The Role of Radiofrequency Ablation for Sacroiliac Joint Pain: A Meta‐Analysis

Wiley - Tập 2 Số 9 - Trang 842-851 - 2010
Steve M. Steve M., Christopher G. Christopher G., Michael Michael, Todd P. Todd P.

Tóm tắt

Radiofrequency ablation (RFA) has become an option for those with chronic or refractory sacroiliac (SI) joint pain. The purpose of this critical review is to assess the existing literature and conduct a meta‐analysis to assess the effectiveness of RFA of the SI joint for pain relief at 3 and 6 months' after an RFA procedure. An electronic search of PubMed, OVID, Medline, and CINAHL were conducted with keywords; sacroiliac joint, sacroiliac pain, sacroiliac syndrome, sacroiliac radiofrequency ablation, sacroiliac neurolysis, sacroiliac injection, and low back pain. Articles that addressed RFA of the SI joint were reviewed. Ten articles ranging from inception to January 1, 2010, were found. The main outcome measure was a reduction of pain by ≥50% post‐RFA procedure. At 3 months, 7 groups met the criteria and at 6 months, 6 groups met the criteria. A meta‐analysis with a forest plot was done at the 3‐ and 6‐month patient follow‐up intervals. The associated standard error was calculated for each study group. An overall weighted average with respective standard error was also obtained. A calculation of 95% confidence intervals (95% CI) was then derived. A test for heterogeneity, publication bias, and file drawer effect was also done at the 3‐ and 6‐month intervals. At 3 months, a range of 0.538‐0.693 was found to have a 95% CI, with a pooled mean of 0.616. At 6 months, a 95% CI of 0.423‐0.576 was found, with a pooled mean of 0.499. The meta‐analysis demonstrated that RFA is an effective treatment for SI joint pain at 3 months and 6 months. This study is limited by the available literature and lack of randomized controlled trials. Further standardization of RFA lesion techniques needs to be established, coupled with prospective randomized controlled trials.

Tài liệu tham khảo

10.1097/00115550-200103000-00008 McKenzie‐Brown A.M., 2005, A systematic review of sacroiliac joint interventions, Pain Physician, 8, 115 Fortin J.D., 1999, Sacroiliac joint innervation and pain, Am J Orthopedics, 28, 687 Vallejo R., 2004, Pulsed radiofrequency denervation for the treatment of sacroiliac joint syndrome, Pain Med, 7, 429, 10.1111/j.1526-4637.2006.00143.x Foley B., 1996, Sacroiliac joint pain: Anatomy, biomechanics, diagnosis, and treatment, Am J Phys Med Rehab, 85, 997, 10.1097/01.phm.0000247633.68694.c1 10.1097/00007632-199611150-00009 10.1097/00007632-199407000-00010 10.5435/00124635-200407000-00006 10.1097/00042752-200307000-00010 Boswell M.V., 2005, Interventional techniques in the management of chronic spinal pain: evidence‐based practice guidelines, Pain Physician, 8, 1, 10.36076/ppj.2006/9/1 10.1163/156856904774134334 10.1213/01.ANE.0000180831.60169.EA Cohen S., 2003, Lateral branch blocks as a treatment for sacroiliac joint pain: A pilot study, Reg Anesth Pain Med, 28, 113 Hansen H.C., 2007, Sacroiliac joint interventions: A systematic review, Pain Physician, 10, 165, 10.36076/ppj.2007/10/165 10.1016/j.rapm.2006.08.008 10.1097/01.ajp.0000131413.07468.8e 10.1111/j.1526-4637.2009.00631.x 10.1007/s11916-000-0019-1 10.1016/j.jpain.2008.09.014 Braun J., 2000, Imaging of sacroiliitis, Clin Rheumatol, 19, 51 10.1007/s00330-001-1257-2 10.7863/jum.2003.22.6.553 10.36076/ppj.2008/11/543 10.1016/j.lpm.2008.09.028 10.1097/00002508-200003000-00004 10.1097/01.BRS.0000085360.03758.C3 10.1007/s11916-004-0038-4 10.1016/j.rapm.2005.03.014 10.1111/j.1526-4637.2005.00076.x 10.3171/jns.1981.55.2.0246 10.1111/j.1540-8167.2005.00216.x 10.1097/ALN.0b013e31817f4c7c 10.1111/j.1533-2500.2008.00231.x 10.1097/AAP.0b013e3181958f4b
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Wiley

Tập 2 Số 9

842-851

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