Twelve‐Month Follow‐Up of a Randomized Trial Assessing Cooled Radiofrequency Denervation as a Treatment for Sacroiliac Region Pain
- 7 January 2015
- journal article
- research article
- Published by Wiley in Pain Practice
- Vol. 16 (2), 154-167
- https://doi.org/10.1111/papr.12269
Abstract
The objective of this study was to report the long-term outcomes of cooled radiofrequency (CRF) lateral branch neurotomy (LBN) as a treatment for sacroiliac (SI) region pain. Whereas the 1-, 3-, 6-, and 9-month outcomes of this procedure compared to sham treatment were previously reported, this current report shows the 12-month outcomes of CRF/LBN treatment for SI region pain.This study originally included 51 subjects who were randomized 2:1 to receive CRF/LBN treatment or a sham intervention, respectively, for SI region pain. Subjects and assessors were blinded for 3 months. At that time, sham participants were permitted to receive CRF/LBN, designated as "crossover" study subjects, and followed for 6 additional months. For the purpose of this evaluation, the original CRF/LBN-treated study subjects were followed for a total of 12 months. Study participants were 18 to 88 years of age and had chronic (symptomatic for >6 months) axial back pain. All subjects were qualified for study inclusion following positive responses to dual lateral branch blocks. Lateral branch neurotomy was performed by CRF to ablate the S1 to S3 lateral branches and the L5 dorsal ramus. Pain was measured by a numerical rating scale (NRS) and Short Form 36-bodily pain (SF36-BP) scores. The Oswestry disability index and Short Form 36-physical functioning (SF36-PF) assessment each served to evaluate subject disability. Treatment successes ("responders") in the originally treated CRF/LBN group at 12 months, and in the crossover group at 6 months, were also determined.In the original CRF/LBN treatment group, 12-month outcomes compared to baseline were favorable, with a mean 2.7 point drop in the NRS score, a 13.9 decrease in the ODI, and a 15.8 increase in SF-36BP. In the crossover study group, 6-month outcomes were also favorable, with a mean NRS score decrease of 2.5 points, a reduction in ODI of 8.8, and an increase in SF36-BP of 11.9.These favorable 12-month results illustrate the durability of effective CRF/LBN-mediated treatment of SI region pain for selected patients. Furthermore, successful CRF/LBN treatments in unblinded crossover study subjects demonstrate the unlikelihood that such positive outcomes are attributable to a "placebo" effect, and suggest that CRF/LBN is an effective therapeutic option for alleviating pain, and improving physical function and quality of life, with few complications.Keywords
Funding Information
- Kimberly Clark Corp
This publication has 32 references indexed in Scilit:
- Use of Cooled Radiofrequency Lateral Branch Neurotomy for the Treatment of Sacroiliac Joint-Mediated Low Back Pain: A Large Case SeriesPain Medicine, 2013
- Cooled radiofrequency application for treatment of sacroiliac joint painActa Neurochirurgica, 2011
- What Is the Source of Chronic Low Back Pain and Does Age Play a Role?Pain Medicine, 2011
- Cooled Radiofrequency System for the Treatment of Chronic Pain from Sacroiliitis: The First Case‐SeriesPain Practice, 2008
- Randomized Placebo-controlled Study Evaluating Lateral Branch Radiofrequency Denervation for Sacroiliac Joint PainAnesthesiology, 2008
- Epidemics, Evolution, and Sacroiliac Joint PainRegional Anesthesia & Pain Medicine, 2007
- Sacroiliac Joint Pain: A Comprehensive Review of Anatomy, Diagnosis, and TreatmentAnesthesia & Analgesia, 2005
- Sacroiliac Joint PainJournal of the American Academy of Orthopaedic Surgeons, 2004
- Sensory Stimulation-Guided Sacroiliac Joint Radiofrequency Neurotomy: Technique Based on Neuroanatomy of the Dorsal Sacral PlexusSpine, 2003
- Corticosteroid injection of the sacroiliac joint in patients with seronegative spondylarthropathyArthritis & Rheumatism, 1992