1449 - Long-Term Treatment Outcomes and Predictors of Treatment Success Following Sacral Lateral Branch Radiofrequency Neurotomy for Sacroiliac Joint Pain: A Real-World Cohort Study

Objectives: Sacral lateral branch radiofrequency neurotomy (SLBRFN) has been demonstrated as a safe and effective treatment for dorsal sacroiliac joint complex (SIJC) pain. The objective of this study was to expand on the current body of literature to evaluate the effectiveness of SLBRFN in the treatment of SIJC pain in a real-world cohort.

Design: This was a single center, cross-sectional cohort study of patients who underwent SLBRFN. Consecutive patients were identified by CPT code query and contacted for participation. Demographic, clinical and procedural characteristics were collected from the electronic medical record. Treatment success was defined as ≥50% NRS pain score reduction from baseline. Predictors of success were evaluated using Logistic and Poisson regression analyses.

Results: 145 of 194 patients (74.7%) were successfully contacted and completed the outcome survey. Demographics of participants included a mean age of 62.2 years (standard deviation [SD]±13.6); 72.4% female; mean follow-up time of 20.7 months (SD±10.5). 22.6% of patients were taking opioid analgesics prior to SLBRFN. Among patients included in the study, 34.5% (95% CI: 26.7%–42.2%) reported ≥50% NRS reduction and 52.4% (95% CI: 44.3%–60.6%) reported ≥2 point NRS reduction. 57.2% (95% CI: 49.1%–69.3%) reported they “much improved” or greater on the PGIC. Among patients taking prescribed opioids at time of the procedure, 36% (n=12) had discontinued opioids at follow-up. No clinical or demographic factors were found to significantly impact treatment outcomes.

Conclusions:





In a real-world population, SLBRFN was associated with clinically meaningful pain reduction and patient-perceived global improvement. While the proportion of patients achieving large magnitude improvement was lower than reported in previous trials, the duration of pain relief observed amongst responders appeared to be longer. These findings highlight the need for further analysis of factors that impact treatment outcome.