Efficacy of cryoneurolysis versus intra-articular steroid in sacroiliac joint pain: A retrospective, case-control study.

Abstract

Intra-articular steroids provide significant pain relief in sacroiliac joint pain (SIJP), but their action is short-lived. Cryoneurolysis is reported to produce prolonged pain relief in various pain conditions. However, its efficacy has not been evaluated in patients with SIJP. Thus, we compared the efficacy of cryoneurolysis with steroid injections in adult patients with SIJP. This retrospective healthcare records review-based study involved 83 patients with SIJP. Patients were divided into two groups: cases (sacroiliac joint [SIJ] cryoneurolysis, n = 39) and controls (SIJ steroid injection, n = 44). An 11-point numeric pain rating scale (NPRS) was used to assess the pain severity at baseline and immediately, 1, 3 and 6 months post-intervention. A reduction of ≥50% in NPRS score immediately following SIJ cryoneurolysis and steroid injection was considered a successful outcome. The difference between the treatment groups was assessed with a Chi-square test, and P < 0.05 was considered statistically significant. Both cases and controls showed significantly decreased NPRS scores from baseline to immediately, 1 month, 3 months and 6 months postintervention (P < 0.001). However, compared to controls, cases had significantly lower NPRS scores at all time points (all P < 0.001). Moreover, a significantly greater proportion of cases had ≥50% decrease in NPRS score from baseline, that is, 1 month (97.44% vs. 75%, P = 0.004), 3 months (100% vs. 47.73%, P < 0.001) and 6 months (69.23% vs. 27.27%, P < 0.001). Although both cryoneurolysis and intra-articular steroid injections provide significant pain relief immediately, 1, 3 and 6 months postintervention, cryoneurolysis resulted in significantly greater pain relief.