Loh Eldon, Agur Anne M, Burnham Robert S
Department of Physical Medicine and Rehabilitation, Western University, London, ON, Canada.
Lawson Health Research Institute, London, ON, Canada.
Interv Pain Med. 2022 Jul 14;1(3):100118. doi: 10.1016/j.inpm.2022.100118. eCollection 2022 Sep.
An ultrasound (US) guided RFA technique for the SIJ, utilizing bipolar RF cannula placements along the lateral sacral crest (LSC), has been proposed in anatomical studies. This study evaluated changes in pain intensity, function and quality of life following this technique.
Patients achieving ≥50% pain relief on two blocks (one FL- and one US-guided) were included. US-guided SIJ RFA was performed with sequential bipolar lesions using two multitined RF cannulae placed along the LSC. The Pain, Disability, Quality of Life Questionnaire-Spine (PDQQ-S), which includes an 11-point (0-10) numeric rating scale (NRS) for pain intensity, was completed pre-RFA, and 2, 6, 9, 12 and 16 months post-RFA. Outcomes at 2 months post-RFA were compared between US-guided and FL-guided SIJ RFA in participants with previous FL-guided SIJ RFA.
31 patients were included. Statistically significant decreases in pain intensity were observed up to 9 months after US-guided SIJ RFA (Baseline NRS: mean = 6.8 SD = 1.6, 95%CI [6.169, 7.347]; 9 month: mean = 4.8, SD = 2.6, 95%CI [3.891, 5.786]; p = 0.0005), and up to 12 months for PDQQ-S. A clinically significant ≥2 point reduction in pain intensity on the NRS was seen in 48.4% of participants at 9 months. 11 participants had previous FL-guided SIJ RFA; no statistically significant differences were found in pain intensity or PDQQ-S scores between US- and FL-guided SIJ RFA 2-months post-RFA.
Preliminary results suggest that SIJ RFA could be performed using US guidance. Further study is required to establish effectiveness.
解剖学研究中提出了一种用于骶髂关节（SIJ）的超声（US）引导下射频消融（RFA）技术，该技术通过沿骶骨外侧嵴（LSC）放置双极射频套管针来实现。本研究评估了该技术应用后疼痛强度、功能和生活质量的变化。
纳入在两次阻滞（一次荧光透视引导和一次超声引导）后疼痛缓解≥50%的患者。使用沿LSC放置的两个多针射频套管针进行连续双极损伤，实施超声引导下的骶髂关节RFA。在射频消融术前以及术后2、6、9、12和16个月完成疼痛、残疾、生活质量问卷-脊柱（PDQQ-S），其中包括用于疼痛强度的11分（0-10）数字评分量表（NRS）。对既往接受过荧光透视引导下骶髂关节RFA的参与者，比较超声引导和荧光透视引导下骶髂关节RFA术后2个月的结果。
纳入31例患者。超声引导下骶髂关节RFA术后9个月内观察到疼痛强度有统计学意义的下降（基线NRS：平均值=6.8，标准差=1.6，95%CI[6.169,7.347]；9个月：平均值=4.8，标准差=2.6，95%CI[3.891,5.786]；p=0.0005），PDQQ-S在术后12个月内有下降。9个月时，48.4%的参与者在NRS上疼痛强度有临床意义的≥2分降低。11名参与者既往接受过荧光透视引导下的骶髂关节RFA；射频消融术后2个月，超声引导和荧光透视引导下的骶髂关节RFA在疼痛强度或PDQQ-S评分方面未发现统计学显著差异。
初步结果表明，骶髂关节RFA可在超声引导下进行。需要进一步研究以确定其有效性。
