Chapter 5 - Sacroiliac joint radiofrequency ablation

Abstract

Chronic back pain is a condition that is difficult to treat, and it is often debilitating for patients and affects their daily lives. The sacroiliac joint (SIJ) is a common cause of low back pain, and there are many environmental, genetic, and pathologic causes. Although there are variations between individuals, most pain arising in the SIJ is transmitted by the L5 ramus and the S1 to S3 dorsal rami lateral branches. Most chronic back pain is best treated with conservative multimodal therapy, but for certain patients who fail these methods, radiofrequency ablation (RFA) is a viable and effective solution. RFA works by inserting a probe to the site of ablation and running an electrical current, which heats surrounding tissue, inducing nerve destruction. The three most common methods of SIJ RFA are (1) Simplicity, a multilesion probe requiring only one needle insertion point; (2) strip lesioning, which creates a strip of destroyed tissue using bipolar probes; and (3) radiofrequency lesioning, the most traditional method using thermal or cooled RFA probes at the specific nerve site.