Chen Chien-Min, Lee Jae Hwan, Yang Meng-Yin, Jhang Shang-Wun, Chang Kai-Sheng, Ou Su-Wei, Sun Li-Wei, Chen Kuo-Tai
Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Changhua, Taiwan.
Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan.
Neurospine. 2023 Mar;20(1):141-149. doi: 10.14245/ns.2346058.029. Epub 2023 Mar 31.
Sacroiliac joint (SIJ) pain is a common cause of chronic low back pain. Full-endoscopic rhizotomy of lateral branches of dorsal rami innervating SIJ is a potential option for patients' refractory to medical treatment. The full-endoscopic rhizotomy is sometimes challenging under fluoroscopic guidance. This study is to evaluate the effectiveness of the navigation-assisted full-endoscopic rhizotomy for SIJ pain.
The study was a retrospective match-paired study that enrolled consecutive patients undergoing navigation-assisted full-endoscopic rhizotomy for SIJ pain. The patient demographics, clinical outcomes, and operative parameters of endoscopic rhizotomy were compared with conventional cooled radiofrequency ablation (RFA) treatment.
The study enrolled 72 patients, including 36 patients in the endoscopic group. Thirty-six patients in the cooled RFA group were matched by age as the control. The follow-up time was at least 1 year. Patient characteristics were similar between the groups. The navigation-assisted endoscopic rhizotomy operation time was significantly longer than the cooled RFA. The visual analogue scale (VAS) for pain and Oswestry Disability Index (ODI) significantly decreased after each treatment. However, the between-group comparison revealed that the VAS and ODI of the patients after endoscopic rhizotomy were significantly lower than those after the cooled RFA group. There were no postoperative complications in the study.
Navigation-assisted full-endoscopic rhizotomy is an alternative to SIJ pain treatment. Integrating intraoperative navigation can ensure accurate full-endoscopic rhizotomy to provide better durability of pain relief than the cooled RFA.
骶髂关节（SIJ）疼痛是慢性下腰痛的常见原因。对支配骶髂关节的背侧支外侧分支进行全内镜下神经根切断术是药物治疗无效患者的一种潜在选择。在荧光镜引导下进行全内镜下神经根切断术有时具有挑战性。本研究旨在评估导航辅助全内镜下神经根切断术治疗骶髂关节疼痛的有效性。
本研究为回顾性配对研究，纳入连续接受导航辅助全内镜下神经根切断术治疗骶髂关节疼痛的患者。将内镜下神经根切断术的患者人口统计学、临床结果和手术参数与传统冷循环射频消融（RFA）治疗进行比较。
本研究共纳入72例患者，其中内镜组36例。冷循环RFA组36例患者按年龄匹配作为对照。随访时间至少1年。两组患者特征相似。导航辅助内镜下神经根切断术的手术时间明显长于冷循环RFA。每次治疗后疼痛视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）均显著下降。然而，组间比较显示，内镜下神经根切断术后患者的VAS和ODI明显低于冷循环RFA组。本研究中无术后并发症发生。
导航辅助全内镜下神经根切断术是治疗骶髂关节疼痛的一种替代方法。术中整合导航可确保准确的全内镜下神经根切断术，比冷循环RFA提供更好的疼痛缓解持久性。
