Dextrose injection of sacral lateral branches for chronic sacroiliac joint pain

2011 ◽  
Vol 12 (4) ◽  
pp. P69
Author(s):  
P. Satija ◽  
M. Parker ◽  
M. Eckmann ◽  
S. Ramamurthy
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Sacroiliac Joint Pain ◽  
Lateral Branches

Lateral branch blocks

2021 ◽  
pp. 75-82
Author(s):  
Benjamin K. Homra ◽  
Yashar Eshraghi ◽  
Maged Guirguis
Keyword(s):  
Radiofrequency Ablation ◽  
Local Anesthetic ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Lateral Branch ◽  
Ultrasound Technique ◽  
Posterior Aspect ◽  
Sacroiliac Joint Pain ◽  
Lateral Branches

The posterior sacral network is a complex meshwork of lateral branches of the dorsal sacral rami that innervate the posterior aspect of the sacroiliac joint. Pain arising from this joint can be diagnostically targeted using either a fluoroscopic or ultrasound technique to determine if the patient would benefit from radiofrequency ablation of the lateral branches. Injecting local anesthetic near the dorsal foramina using these techniques will temporarily block the transmission of pain by the lateral branches from the sacroiliac joint. This chapter covers the anatomy of the posterior sacral network, discusses the details of the two techniques for lateral branch blocks and evidence for their utility, provides information about the risks and contraindications associated with the techniques, and concludes by discussing the implications of the procedure.

scholarly journals Comparison of Efficacy of Lateral Branch Pulsed Radiofrequency Denervation and Intraarticular Depot Methylprednisolone Injection for Sacroiliac Joint Pain

2018 ◽  
Vol 1 (21;1) ◽  
pp. 489-496
Author(s):  
Samarjit Dey
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Pulsed Radiofrequency ◽  
Sacroiliac Joint Pain ◽  
Post Procedure ◽  
Radiofrequency Denervation ◽  
Group A ◽  
Dorsal Rami ◽  
Group B ◽  
Lateral Branches

Background: Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it be the diagnosis or the treatment. Diagnostic blocks are the gold standard way to diagnose this condition. Radiofrequency neurotomy of the nerves supplying the sacroiliac joint has shown equivocal results due to anatomical variation. Intraarticular depo-steroid injection is a traditional approach to treating sacroiliac joint pain. For long-term pain relief, however, lesioning the sacral lateral branches may be a better approach. Objective: This study compared the efficacy of intraarticular depo-methylprednisolone injection to that of pulsed radiofrequency ablation for sacroiliac joint pain. Study Design: This study used a randomized, prospective design. Setting: Thirty patients with diagnostic block-confirmed sacroiliac joint dysfunctional pain were randomly assigned to 2 groups. One group received intraarticular methylprednisolone and another group underwent pulsed radiofrequency of the L4 medial branch, the L5 dorsal rami, and the lateral sacral branches. Results: Reduction in Numeric Rating Scale (NRS) for pain at 1 month post-procedure remained similar in Group A, while in Group B few patients reported a further decrease in the NRS score (3.333 ± 0.4880 and 2.933 ± 0.5936, respectively). At 3 months post-procedure, the NRS score began to rise in most patients in group A, while in Group B, the NRS score remained the same since the last visit (4.400 ± 0.9856 and 3.067 ± 0.8837, respectively). At 6 months post-procedure, the NRS score began to rise further in most patients in group A. In Group B, the NRS score remained the same in most of the patients since the last visit (5.400 ± 1.549 and 3.200 ± 1.207). There was a marked difference between the 2 groups in Oswestry Disability Index (ODI) scores at 3 months post-procedure (Group A, 12.133 ± 4.486 vs Group B, 9.133 ± 3.523) and at 6 months post-procedure there was a significant (P = 0.0017) difference in ODI scores between Group A and Group B (13.067 ± 4.284 and 8.000 ± 3.703, respectively). Global Perceived Effect (GPE) was assessed in both groups at 3 months post-procedure Only 33.3% (Confidence Interval (CI) of 11.8- 61.6 ) of patients in Group A had positive GPE responses whereas in Group B, 86.67% (CI of 59.5- 98.3 ) of patients had positive GPE responses. At 6 months post-procedure, the proportion of patients with positive GPE declined further in Group A, while in Group B, positive GPE responses remained the same (20% with a CI of 4.30- 48.10 and 86.67% with a CI of 59.5- 98.3, respectively ). Limitations: Small sample size. Conclusion: This comparative study shows that pulsed radiofrequency denervation of the L4 and L5 primary dorsal rami and S1-3 lateral branches provide significant pain relief and functional improvement in patients with sacroiliac joint pain. Key words: Low back pain, sacroiliac joint dysfunctional pain, radiofrequency, intraarticular injection

Comparative Outcomes of Cooled Versus Traditional Radiofrequency Ablation of the Lateral Branches for Sacroiliac Joint Pain

2013 ◽  
Vol 29 (2) ◽  
pp. 132-137 ◽  
Author(s):  
Jianguo Cheng ◽  
Jason E. Pope ◽  
Jarrod E. Dalton ◽  
Olivia Cheng ◽  
Albatoul Bensitel
Keyword(s):  
Radiofrequency Ablation ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Sacroiliac Joint Pain ◽  
Lateral Branches

scholarly journals Novel Single Puncture Approach for Simplicity 3 Sacral Plexus Radiofrequency Ablation: Technical Note

2016 ◽  
Vol 4;19 (4;5) ◽  
pp. E643-E648
Author(s):  
Christopher J. Gilligan
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Bowel Perforation ◽  
Technical Note ◽  
Thin Wall ◽  
Rf Ablation ◽  
Procedure Time ◽  
Sacral Plexus ◽  
Sacroiliac Joint Pain ◽  
Lateral Branches

Radiofrequency (RF) ablation of the lateral sacral plexus has been used for the treatment of sacroiliac joint pain including as an adjunct to other palliative therapies for the treatment of painful osseous metastasis. The treatment goal is targeted ablation of the dorsal lateral branches of S1-S4. Though several techniques have been described, the Simplicity III (Neurotherm, Middleton, MA) system allows for ablation to be achieved with a single RF probe by utilizing a multi-electrode curved RF probe to create a continuous ablation line across all sacral nerves. In the standard approach, there is sequential introduction of a spinal needle along the desired ablation tract for local anesthesia followed by separate placement of the ablation probe. Though fluoroscopic guidance is utilized, multiple needle passes increase the risk of complication such as bowel perforation or probe insertion through a neural foramen. It may also extend procedure time and increase radiation dose. We illustrate a technique for Simplicity III RF ablation of the dorsal sacral plexus using a modified Seldinger approach for treatment of a patient with sacroiliac joint pain due to osseous renal cell carcinoma metastasis. The desired ablation tract is initially anesthetized via a hollow micropuncture needle. The needle is then exchanged for a peelaway sheath. The RF probe is inserted through the peelaway sheath thus ensuring the probe is placed precisely along the previously anesthetized tract allowing the procedure to be completed using a single percutaneous puncture. We believe that this approach decreases the risks of bowel perforation, patient discomfort as a result of multiple percutaneous punctures, and procedure time. Key words: Simplicity 3, sacral plexus ablation, image-guided approach, modified Seldinger, chronic sacral pain, thin wall introducer needle

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