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Lateral Branch Blocks as a Treatment for Sacroiliac Joint Pain: A Pilot Study
  1. Steven P. Cohen, M.D. and
  2. Salahadin Abdi, M.D., Ph.D.
  1. From the Pain Management Center, Departments of Anesthesiology, Walter Reed Army Medical Center, Washington, D.C., and New York University School of Medicine (S.P.C.), New York, New York; and Massachusetts General Hospital Pain Center, Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School (S.A.), Boston, Massachusetts.
  1. Reprint requests: Steven P. Cohen, M.D., NYU Pain Management Center, 317 East 34th St, 9th Fl, New York, NY 10016. E-mail: Steven.Cohen{at}med.nyu.edu

Abstract

Background and Objectives Pain arising from the sacroiliac (SI) joint is a common cause of low back pain for which there is no universally accepted, long-term treatment. Previous studies have shown radiofrequency (RF) procedures to be an effective treatment for other types of spinal pain. The purpose of this study was to determine the efficacy of reducing SI joint pain by percutaneous RF lesioning of the nerves innervating the SI joint.

Methods Eighteen patients with confirmed SI joint pain underwent nerve blocks of the L4-5 primary dorsal rami and S1-3 lateral branches innervating the affected joint. Those who obtained 50% or greater pain relief from these blocks proceeded to undergo RF denervation of the nerves.

Results Thirteen of 18 patients who underwent L4-5 dorsal rami and S1-3 lateral branch blocks (LBB) obtained significant pain relief, with 2 patients reporting prolonged benefit. At their next visit, 9 patients who experienced >50% pain relief underwent RF lesioning of the nerves. Eight of 9 patients (89%) obtained ≥50% pain relief from this procedure that persisted at their 9-month follow-up.

Conclusions In patients with SI joint pain who respond to L4-5 dorsal rami and S1-3 LBB, RF denervation of these nerves appears to be an effective treatment. Randomized, controlled trials are needed to further evaluate this procedure.

  • Injection
  • Low back pain
  • Radiofrequency
  • Sacroiliac joint

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Footnotes

  • Presented at the First Joint World Congress of Regional Anaesthesia and Pain Therapy, May 29-June 1, 2002, Barcelona, Spain.

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