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

Abstract

Background: the sacroiliac joint is a source of low back pain. Steroid injection has been long used in the treatment of sacroiliac joint pain, yet sacroiliac joint lateral branch radiofrequency denervation provides a more durable alternative. Aim: comparison of sacroiliac joint pain relief after intra- articular steroid injection and radiofrequency denervation of lateral branches, and comparison of improved daily activities, and general satisfaction of patients Methods: study involved 30 patients , confirmed to have sacroiliac joint pain by clinical provocation tests alongside more than 50% pain relief after intra-articular diagnostic block injection. Patients were randomized into 2 groups with group A for intra-articular methylprednisolone injection and group B for L4 L5 dorsal rami and S1-3 lateral branch conventional radiofrequency denervation. Results: In group A (intra-articular methylprednisolone injection) NRS outcome with>50% pain relief after 2weeks, 1months and 3 months was 60% (9out of 15 patients), reduced to 46%(7 out of 15 patients), and further reduced to 40% (6 out of 15patients) respectively with only 6 patients reported improvement of daily activities and would recommend the procedure for other patients compared to group B ( L4 L5 dorsal rami and S1-3 lateral branch conventional radiofrequency denervation) where NRS outcome with >50% pain relief at 2weeks, 1months and 3 months was 60% with 9 out 15 patients report improvement of pain along 3 months with 9 patients report improvement of daily activities. Conclusion: The comparative study showed that Use of RF neurotomy as an intervention for sacroiliac joint pain led to improved function