A NEW RADIOFREQUENCY ABLATION PROCEDURE TO TREAT SACROILIAC JOINT PAIN
Authors: Cheng J, Chin S.L, Zimmerman N, Dalton J.E, La Salle G, Rosenquist R.W
Study type: Methodology development. Prospective non-randomized trial.
Publication: Pain Physician 2016; 19:603-615 (Link to PubMed)
Key Words: Chronic Low back pain – Sacroiliac Joint – bipolar RF vs cooled RF - Palisade™
Graphs created by Boston Scientific based on the published data.
In this study, the authors developed a novel bipolar radiofrequency (bRFA) ablation technique to relieve pain secondary to SIJ disorders. This study also compared the effectiveness of bRFA ablation with cooled RF (cRFA).
- Devise a guide-block device that facilitates accurate placement of multiple electrodes to simultaneously ablate the L5 dorsal ramus and lateral branches of the S1, S2, and S3 dorsal rami.
- Use of bipolar RF ablation to create a strip-like lesion covering from the lateral border of the base of the sacral superior articular process (L5-S1 facet joint) to the lateral border of the S3 sacral foramen.
- Apply this novel technique in N=31 patients and compare the procedural and clinical outcomes with a group of N=62 patients who were treated with cRFA.
- Study outcomes included: Pain relief at one-year follow-up, operating time, and radiation exposure and dose.
- bRFA, aided by the new guide-block device (Palisade™), provided satisfactory pain relief (p<0,001. 1, 3, 6, and 12 months), and demonstrated to be clinically and statistically superior to cRFA.
- Operating time and X-ray exposure were reduced by >50% and >80%, respectively. Procedural costs were reduced by > $1,000 per case.
This new method of RF ablation is safe, efficacious, and cost-effective.