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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ultrasound guided sacral lateral branch radiofrequency ablation | Experimental | Patients in this group will receive sacral lateral branch radiofrequency ablation under ultrasound guidance. |
|
| Fluoroscopy guided sacral lateral branch radiofrequency ablation | Active Comparator | Patients in this group will receive sacral lateral branch radiofrequency ablation under fluoroscopy guidance. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sacral lateral branch radiofrequency ablation under ultrasound guidance | Procedure | Sacral lateral branch radiofrequency ablation will be performed under ultrasound guided approach. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in pain numerical rating score from baseline | The numerical rating score (NRS) will be used to assess the severity of pain felt by a patient. . The patient rates pain on a scale of 0 to 10; 0 represents 'no pain' and 10 ,represents 'worst pain imaginable' | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Performance time | Radiofrequency ablation performance time will be recorded from the time the first image is obtained, until the procedure is completed | During the procedure |
| Patient satisfaction |
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Inclusion Criteria:
Low back pain due to sacroiliac joint dysfunction >6 months with a score ≥ 4 on a numeric rating scale.
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;
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Health Science University Diskapi Yildirim Beyazıt Training and Research Hospital | Yenimahalle | Ankara | 06170 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28178092 | Background | Finlayson RJ, Etheridge JB, Elgueta MF, Thonnagith A, De Villiers F, Nelems B, Tran DQ. A Randomized Comparison Between Ultrasound- and Fluoroscopy-Guided Sacral Lateral Branch Blocks. Reg Anesth Pain Med. 2017 May/Jun;42(3):400-406. doi: 10.1097/AAP.0000000000000569. | |
| 25247902 | Background | Cox RC, Fortin JD. The anatomy of the lateral branches of the sacral dorsal rami: implications for radiofrequency ablation. Pain Physician. 2014 Sep-Oct;17(5):459-64. |
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Findings of this study will be available from the principle investigator upon reasonable request.
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| Sacral lateral branch radiofrequency ablation under fluoroscopy guidance | Procedure | Sacral lateral branch radiofrequency ablation will be performed under fluoroscopy guided approach. |
|
Changes in overall satisfaction will be assessed using a 5-point Likert scale. (1, very dissatisfied; 2, dissatisfied; 3, neutral; 4, satisfied; 5, very satisfied).
| At 3 months |
| Pain medication use | Mean change in analgesic consumption is assessed using QAQ, a tool designed to record patient-reported pain medication use. The higher score indicates higher pain medication use | At 3 months |
| Success rate | Proportions of reporting >50% pain relief. | At 3 months |
| Functional disability | Change in Oswestry Disabilit Index ( Scale 0-100). 0 point is equated with no disability and 100 point is maximum disability possible | At 1 and 3 months |
| Quality of life ( SF-36) | Quality of life (QoL) will assessed via SF-36, which consists of 36 items ad 2 summary values for Physical Component Summary ( PSC) and Mental Component Summary (MSC). Subscale scores range from 0 to 100, with 100 being the most positive QoL in that area and 0 the lowest; | At 1 and 3 months |
| The number of needle passess | The number of attempts during the performance will be analysed. | During the procedure |
| ID | Term |
|---|---|
| D058566 | Sacroiliitis |
| D001416 | Back Pain |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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