Presented at the 2012 AAPM Annual Meeting « Back

The Degree of Pain Relief from Intraarticular Steroid Injection of the Sacroiliac Joint Does Not Predict the Outcomes of Radiofrequency Ablation of the Lateral Branches

Jianguo Cheng, MD PhD, chengj@ccf.org¹, Jason Pope, MD¹, Jarrod Dalton, MS¹, Cleveland Clinic, Cleveland, Ohio

We aimed to determine if the degree of pain relief after sacroiliac joint (SIJ) steroid injection is predictive of the duration of pain relief after radiofrequency ablation (RFA) of the lateral branches. With IRB approval, we collected data from 80 patients undergoing radiofrequency ablation. The degree of pain relief as a result of SIJ injection was characterized as either <50% (in 20 patients) or ≥50% (in 60 patients). Our primary outcome is the duration of pain relief after RFA, defined as the time until the patient reported <50% pain relief. Before adjusting for potential confounders, we did not find a significant univariable relationship between the degree of pain relief after steroid injection and duration of pain relief after RFA (P = 0.91, Sun’s test). After adjusting for such variables as age, modes of pain onset, multiple pain complaints, and responses to extension or axial rotation of the lumbar spine in the multivariable proportional hazards model, the difference in duration of post-RFA pain relief between the two groups (≥50% or <50% pain relief) remained insignificant (P = 0.91, hazard ratio [95% confidence interval] of 0.96 [0.49, 1.90]. In conclusion, we found no evidence that post-RFA pain relief differed between patients who experienced ≥50% pain relief after SIJ steroid injection and patients who experienced <50% pain relief, even after adjustment for potential confounders. Thus the degree of pain relief after SIJ steroid injection is a poor predictor of the efficacy of RFA.

Funding: Internal funding from the Anesthesiology Institute of Cleveland Clinic supported part of the study.