Korean J Pain.  2016 Jan;29(1):53-56. 10.3344/kjp.2016.29.1.53.

Pulsed Radiofrequency Application for the Treatment of Pain Secondary to Sacroiliac Joint Metastases

• Yi YR
• Lee NR
• Kwon YS
• Jang JS
• Lim SY

• KMID: 2151661
• DOI: http://doi.org/10.3344/kjp.2016.29.1.53

Abstract

Sacroiliac (SI) joint pain can result from degeneration, infection, malignancy, and trauma. Patients with metastatic bone pain who do not respond to conventional treatment may need more aggressive neuroinvasive approaches. Recently, pulsed radiofrequency (PRF) neuromodulation has emerged as a promising treatment alternative for refractory cases of SI joint pain. Nevertheless, there is no report on the treatment of pain arising from SI joint metastases with PRF. We are reporting about a 63-year-old woman suffering from buttock pain due to breast cancer metastases in the SI joint. We treated this patient with PRF neuromodulation of the L4-S3 primary dorsal rami and lateral branches using a rotating curved needle technique. The patient tolerated the procedures well, without any complications. She experienced about 70% reduction in pain, and pain relief was sustained for 10 months. This result suggests that PRF neuromodulation is a safe, effective treatment for pain from SI joint metastases.

Keyword

Cancer; Metastases; Neuromodulation; Pain; Pulsed radiofrequency; Sacroiliac joint

MeSH Terms

Arthralgia
Breast Neoplasms
Buttocks
Female
Humans
Joints
Middle Aged
Needles
Neoplasm Metastasis*
Sacroiliac Joint*

Figure

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  Fig. 1 (A) Axial computed tomography scan with the bone setting reveals metastatic lesions in the sacrum and ilium. (B) Bone scan shows evidence of metastases in multiple ribs, sacrum, sacroiliac joint, spine, and femur.

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  Fig. 2 (A) Anteroposterior radiograph shows the cannula tip for both the S1 and left S2 lateral branches in a sacroiliac joint radiofrequency neurotomy. (B) An oblique image of the lumbar spine. The cannula tip is positioned at the L4, L5 dorsal ramus.

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