Purpose of Technology: Radiofrequency ablation (RFA) is a percutaneous treatment for chronic low back pain (LBP), including pain originating in the sacroiliac joint (SIJ), using radiowave-induced heat to create a lesion in a spinal sensory nerve. Following a diagnostic blockade to target the affected nerve(s), radiofrequency (RF) current is applied for several minutes via a needle electrode to denervate the targeted nerve(s) under image guidance. In the SIJ, RFA procedures typically target branches of the S1-S3 lateral sensory nerves, as well as the L5 dorsal ramus, with the overall aim of preventing transmission of pain signals to the central nervous system (denervation).
Rationale: The goal of treatment is to relieve pain and related symptoms in patients who are not responding adequately to conservative therapy.
Controversy: The effects of RFA denervation are not permanent, and may last from 6 months to 1 year or longer.
For patients with chronic nonspecific LBP associated with the SIJ, are conventional (thermal) and cooled RFA effective for alleviating pain, improving function, and improving quality of life?
Are both conventional and cooled RFA safe for patients with chronic nonspecific LBP associated with the SIJ?
How do conventional RFA and cooled RFA compare with sham therapy, steroid injections, and other alternatives for relief of pain and symptoms related to chronic nonspecific LBP associated with the SIJ?
Have definitive patient selection criteria been established for conventional and cooled RFA for chronic nonspecific LBP associated with the SIJ?
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