Endoscopic and Cryoablation Denervation for Sacroiliac Joint Pain

Prospective Study Evaluating Cryoablation and Endoscopic Denervation of the Dorsal Sacroiliac Joint Innervation (Ramus Dorsalis L5 and S1-S3) in Patients With Sacroiliac Joint Pain

This interventional study compares cryoablation and endoscopic denervation for the treatment of posterior sacroiliac joint pain in patients with chronic sacroiliac joint pain confirmed by a positive diagnostic block. The aim is to evaluate and compare the effectiveness of both procedures in reducing pain and improving functional status.

Posterior sacroiliac joint pain is a common cause of chronic low back pain and may substantially impair daily functioning and quality of life. In patients with a positive diagnostic block confirming the sacroiliac joint as the source of pain, interventional procedures targeting the dorsal branches of L5 and S1-S3 may provide pain relief.

This study compares two interventional treatment methods: cryoablation and endoscopic denervation. Patients with confirmed posterior sacroiliac joint pain undergo one of these procedures after diagnostic confirmation of the pain source. Cryoablation is performed on the dorsal branches of L5 and S1-S3. Endoscopic denervation is performed on the same target nerves using an endoscopic approach.

The study evaluates the comparative effectiveness of these procedures in terms of pain reduction and functional improvement over follow-up. The findings may help clarify the role of these two techniques in the management of chronic posterior sacroiliac joint pain.

Inclusion Criteria:

• adults aged 18 years or older
• chronic sacroiliac joint pain
• positive sacroiliac joint provocation maneuvers
• positive diagnostic block of the dorsal branches of L5 and S1-S3 under fluoroscopic guidance
• at least 70% pain relief after diagnostic block
• ability to understand the study procedures and provide written informed consent

Exclusion Criteria:

• radicular pain caused by lumbar disc herniation or other dominant spinal pathology
• spinal tumor, infection, fracture, or inflammatory spinal disease
• coagulation disorder or ongoing anticoagulant therapy contraindicating the procedure
• pregnancy
• severe psychiatric or medical condition preventing reliable follow-up
• refusal to participate in the study