Fluoroscopy Versus Ultrasound Guidance for Sacral Lateral Branch Radiofrequency Ablation

Diskapi Teaching and Research Hospital

Status: Completed

Conditions: Back Pain; Sacroiliac Joint Arthritis

Treatments: Procedure: Sacral lateral branch radiofrequency ablation under ultrasound guidance; Procedure: Sacral lateral branch radiofrequency ablation under fluoroscopy guidance

Study type: Interventional

Funder types: Other

Identifiers

NCT05520463

127/23

Details and patient eligibility

About

Sacroiliac joint is a diarthroidal and synovial joint that receives sensory innervatin by the sacral lateral branches ( commonly S1-3, with variable contributions from L5 dorsal ramus and S4 lateral branch). Sacral lateral branch radiofrequency ablation and block techniques are widely used for the management of sacroiliac joint pain. With the increasing use of ultrasound technology in pain medicine, the ultrasound guided approaches gained popularity. To our knowledge, there are no randomized controlled trials comparing the ultrasound and fluoroscopy approaches for sacral lateral branch radiofrequency ablation. This study aims to compare the ultrasound and fluoroscopy guidance techniques for sacral lateral branch radiofrequency ablation.

Enrollment: 60 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Low back pain due to sacroiliac joint dysfunction >6 months with a score ≥ 4 on a numeric rating scale.

  • 50% pain relief after prognostic sacral lateral branch block

• At least 3 positive physical examination maneuvers [ Faber ( flexioni abduction and external rotation), POSH (posteripr shear), REAB ( resisted abduction), Gaenslen's test, Distraction test]

• Refractory to conservative therapy

Exclusion Criteria: The exclusion criteria were;

• Uncontrolled psychiatric or neurological illness
• Sacroiliac joint pain due to other disorders,
• Lumbar radiculopathy
• Rheumatological diseases
• Systemic active infections
• Malignancies, previous surgery on the affected sacroiliac joint,
• History of traumatic hip injury,
• History of bleeding disorders,
• Platelet values < 150.000 / µl,
• Sacroiliac joint injection within the preceding 3 months,
• Allergy to local anesthetics and steroids,
• Pregnancy, inability to concent, Implanted pacemaker or defibrilator.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

Ultrasound guided sacral lateral branch radiofrequency ablation

Experimental group

Description:

Patients in this group will receive sacral lateral branch radiofrequency ablation under ultrasound guidance.

Treatment:

Procedure: Sacral lateral branch radiofrequency ablation under ultrasound guidance

Fluoroscopy guided sacral lateral branch radiofrequency ablation

Active Comparator group

Description:

Patients in this group will receive sacral lateral branch radiofrequency ablation under fluoroscopy guidance.

Treatment:

Procedure: Sacral lateral branch radiofrequency ablation under fluoroscopy guidance