Sacroiliac radiofrequency ablation, or rhizotomy, is used for the long-term reduction of pain in the lower sacroiliac joint by “burning” the posterior L5, S1, S2 and S3 branches.
The sacroiliac joint can be the source of pain generally localized in the lumbosacral region. Patients who have experienced significant but temporarily relief through sacroiliac injection under fluoroscopic guidance can benefit from sacroiliac ablation. The final selection of the patient is made by anesthetizing the lateral branches innervating the sacoiliac joint.
If the diagnostic test is positive, the first studies have shown that most patients improve. Relief, if present, usually lasts about 2 years since there may be regrowth of side branches. If so, the treatment can be repeated.
After disinfecting the skin and anesthetizing it if necessary, the doctor ensures the correct position of the trocar on the path of the lateral branch. Local anesthesia is given and the needle is connected to a radio frequency device. A current will heat the end of the trocar according to a well-defined protocol, thus burning the posterior lateral branch.
The specialist doctor will make sure to make lesions at several specific points between the sacred holes and the sacroiliac joint to destroy the various lateral branches. A special trocar (Trident) or a quad-polar technique will be used to allow burning all the places where the lateral branches can be found due to non-negligible personal variability.
After the procedure, the patient may feel numbness or weakness in a limb due to the anesthetic administered during the procedure. These temporary symptoms may last from a few minutes to a few hours.
Complications are essentially related to the injection, the anatomy involved and the substances injected. Using radiography to confirm the trajectory of the trocar enhances the safety of the procedure. The low-intensity electrical stimulation administered before the treatment also helps prevent complications. The risks of complications, such
This procedure is contraindicated during pregnancy. Please note that ablation cannot be performed on patients who have a pacemaker. It is usually not necessary to stop taking anti-coagulants or antiplatelet drugs.
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