Abstract
Since the beginning of the last century, the significance of the sacroiliac joint as a possible pain generator has been disputed. It was not until the 1990s that intra-articular injections reproducibly demonstrated a reduction in pain from deep lumbar unilateral pain, thus bringing the sacroiliac joint to the fore as a pain generator. Diagnostics are problematic; no single clinical test reliably demonstrates dysfunction of the SIG joint. Therefore, a combination of clinical tests or a standardized injection at the SIG complex, taking into account the ligamentous structures, must be performed to verify SIG dysfunction. The anatomical peculiarities of the large variance of the dorsal branches supplying the SIG will be addressed, as well as technical peculiarities in performing radiofrequency denervation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Cohen SP, Abdi S (2003) Lateral branch blocks as a treatment for sacroiliac joint pain: a pilot study. Reg Anesth Pain Med 28:113–119
Cohen SP, Hurley RW, Buckenmaier CC, Kurihara C, Morlando B, Dragovich A (2008) Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology 109:279–288
Cohen SP, Chen Y, Neufeld NJ (2013) Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother 13:99–116
Dreyfuss P, Snyder BD, Park K, Willard F, Carreiro J, Bogduk N (2008) The ability of single site, single depth sacral lateral branch blocks to anesthetize the sacroiliac joint complex. Pain Med 9:844–850. https://doi.org/10.1111/j.1526-4637.2008.00517.x
Dreyfuss P, Henning T, Malladi N, Goldstein B, Bogduk N (2009) The ability of multi-site, multi-depth sacral lateral branch blocks to anesthetize the sacroiliac joint complex. Pain Med 10:679–688. https://doi.org/10.1111/j.1526-4637.2009.00631.x
Dussault RG, Kaplan PA, Anderson MW (2000) Fluoroscopy-guided sacroiliac joint injections. Radiology 214:273–277. https://doi.org/10.1148/radiology.214.1.r00ja28273
Fortin JD, Aprill CN, Ponthieux B, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part II: clinical evaluation. Spine (Phila Pa 1976) 19:1483–1489
Goldthwait JE (1911) The lumbo-sacral articulation; an explanation of many cases of lumbago, sciatica and paraplegia. Boston Med Surg J 164:365–372
Grob KR, Neuhuber WL, Kissling RO (1995) Innervation of the sacroiliac joint of the human. Z Rheumatol 54:117–122
Ho K-Y, Hadi MA, Pasutharnchat K, Tan K-H (2013) Cooled radiofrequency denervation for treatment of sacroiliac joint pain: two-year results from 20 cases. J Pain Res 6:505
Ikeda R (1991) Innervation of the sacroiliac joint. Macroscopical and histological studies. Nihon Ika Daigaku Zasshi 58:587–596. https://doi.org/10.1272/jnms1923.58.587
Kapural L, Nageeb F, Kapural M, Cata JP, Narouze S, Mekhail N (2008) Cooled radiofrequency system for the treatment of chronic pain from sacroiliitis: the first case-series. Pain Pract 8:348–354
Katz V, Schofferman J, Reynolds J (2003) The sacroiliac joint: a potential cause of pain after lumbar fusion to the sacrum. J Spinal Disord Tech 16:96–99
Laslett M, Aprill CN, McDonald B, Young SB (2005) Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 10:207–218. https://doi.org/10.1016/j.math.2005.01.003
Longo UG, Loppini M, Berton A, Laverde L, Maffulli N, Denaro V (2014) Degenerative changes of the sacroiliac joint after spinal fusion: an evidence-based systematic. Br Med Bull 112:47–56
Manchikanti L et al (2013) An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician 16:S49–S283
Patel N, Gross A, Brown L, Gekht G (2012) A randomized, placebo-controlled study to assess the efficacy of lateral branch neurotomy for chronic sacroiliac joint pain. Pain Med 13:383–398. https://doi.org/10.1111/j.1526-4637.2012.01328.x
Roberts SL, Burnham RS, Ravichandiran K, Agur AM, Loh EY (2014) Cadaveric study of sacroiliac joint innervation: implications for diagnostic blocks and radiofrequency ablation. Reg Anesth Pain Med 39:456–464. https://doi.org/10.1097/AAP.0000000000000156
Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N (1994) Clinical features of patients with pain stemming from the lumbar zygapophysial joints. Is the lumbar facet syndrome a clinical entity? Spine (Phila Pa 1976) 19:1132–1137
Stelzer W, Aiglesberger M, Stelzer D, Stelzer V (2013) Use of cooled radiofrequency lateral branch neurotomy for the treatment of sacroiliac joint-mediated low back pain: a large case series. Pain Med 14(1):29–35
Szadek KM, van der Wurff P, van Tulder MW, Zuurmond WW, Perez RS (2009) Diagnostic validity of criteria for sacroiliac joint pain: a systematic review. J Pain 10:354–368
Van Zundert JV, Hartrick C, Patijn J, Huygen F, Mekhail N, van Kleef M (2011) Evidence-based interventional pain medicine according to clinical diagnoses. Pain Pract 11:423–429. https://doi.org/10.1111/j.1533-2500.2011.00490.x
Willard F (1998) The long posterior interosseous ligament and the sacrococcygeal plexus. In: Third interdisciplinary world congress on low back and pelvic pain, Chicago
Young S, Aprill C, Laslett M (2003) Correlation of clinical examination characteristics with three sources of chronic low back pain. Spine J 3:460–465. https://doi.org/10.1016/S1529-9430(03)00151-7
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer-Verlag GmbH Germany, part of Springer Nature
About this chapter
Cite this chapter
Schneider, M. (2023). Radiofrequency Denervation of the Sacroiliac Joint. In: Jerosch, J. (eds) Minimally Invasive Spine Intervention. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63814-9_12
Download citation
DOI: https://doi.org/10.1007/978-3-662-63814-9_12
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-63813-2
Online ISBN: 978-3-662-63814-9
eBook Packages: MedicineMedicine (R0)