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Sacroiliac joint neuroablation using Quadrapolar™ radiofrequency lesioning: a small center experience
Author(s): ,
V. Sá Pinto
Affiliations:
Centro Hospitalar do Porto, Neurosurgery Department, Porto, Portugal
,
F. Silva
Affiliations:
Centro Hospitalar do Porto, Neurosurgery Department, Porto, Portugal
,
E. Cunha
Affiliations:
Centro Hospitalar do Porto, Neurosurgery Department, Porto, Portugal
,
C. Silva
Affiliations:
Centro Hospitalar do Porto, Neurosurgery Department, Porto, Portugal
A. Calheiros
Affiliations:
Centro Hospitalar do Porto, Neurosurgery Department, Porto, Portugal
EANS Academy. Sá Pinto V. Oct 21, 2018; 226002; EP7028
Vasco Sá Pinto
Vasco Sá Pinto
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Abstract
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The sacroiliac joint is a common source of chronic low back pain and its denervation by radiofrequency ablation (RFA-SIJ) is a frequently performed intervention. Various different RFA-SI techniques have been described but high-quality evidence for its effectiveness are still lacking.

We performed a descriptive and inferential retrospective analysis of the RFA-SIJ performed at our center utilizing the Quadrapolar™ (Diros Technology) technique. The demographical, clinical and procedural characteristics were described and pain control results were summarized.

A total of 39 cases were identified. We observed a female gender predominance (74%) and average age at procedure was 55.1 years. All patients had tested positive on a previous invasive diagnostic test (percutaneous pharmacological neuroblockade). Average time between diagnostic test and RFA-SIJ was 9.6 months. Average follow-up time was 22 months. At 1 month-post procedure, 70% of patients achieved symptomatic improvement, including 45% of total pain resolution and 63% pain medication eviction. These values remained stable at 6-months and one year post-op evaluations. At last follow-up, 27% of patients with total pain resolution relapsed. On a logistic regression model, male gender and previous spine surgery were identified as risk factors for pain control failure (OR=12.0, p=0.031 and OR=8.83, p=0.022, respectively). On actuarial analysis, longer interval between diagnostic test and RFA-SIJ was associated with shorter recurrence-free survival (p=0.035), although we found no association between pain relief duration after diagnostic test and outcome.

In conclusion, Quadrapolar™ RFA-SIJ is a useful tool for the management of sacroiliac joint pain. Although further studies are needed, male gender and previous spine surgery appear to be risk factors for pain control failure and reducing the interval between diagnostic test and RFA-SIJ might maximize benefits.
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