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Sacroiliac Joint Radiofrequency Rhizotomy

What does “Sacroiliac Joint Radiofrequency Rhizotomy” mean?

Here is the meaning of each word:

  1. Sacroiliac Joint: the joint between the tailbone (sacrum) and part of the pelvis (ilium).
  2. Radiofrequency: a form of energy which can produce heat.
  3. Rhizotomy: to disrupt a nerve.

Altogether, “Sacroiliac Joint Radiofrequency Rhizotomy” means to use targeted heat energy, to disrupt a nerve traveling to the joint between the tailbone and pelvis.

Why is a “Sacroiliac Joint Rhizotomy” done?

A Sacroiliac Joint Rhizotomy is often done to try to provide the patient with longer lasting pain relief. A Sacroiliac Joint Injection is done first to make sure this joint is the cause of the patient’s low back pain. If this injection does provide relief but only for a short period of time, a Sacroiliac Joint Rhizotomy is often done in hopes of providing longer lasting relief.

How does Radiofrequency Energy disrupt a nerve?

Radiofrequency energy can deliver very target high temperature energy to a nerve. This energy disrupts the nerve’s ability to transmit information. In the case of a facet joint nerve (medial branch), the nerve cannot relay information to the spinal cord and brain that the facet joint is inflamed and painful.

What is the difference between a Sacroiliac Joint Injection, a Sacroiliac Joint Radiofrequency Rhizotomy and a Sacroiliac Joint Fusion?

1. A Sacroiliac Joint Injection is initially done to diagnose if the patient’s pain is coming from the Sacroiliac Joint. If it is very helpful for a significant period of time, this injection can be repeated.

2. A Sacroiliac Joint Radiofrequency Rhizotomy tries to disrupt the small nerves traveling to the Sacroiliac Joint using targeted heat energy. This procedure is often done if Sacroiliac Joint Injections are not helping for long period of time. This procedure is a minimally invasive procedure done with needles.

3. A Sacroiliac Joint Fusion is done when neither Sacroiliac Joint Injections or Sacroiliac Joint Radiofrequency Rhizotomies give a patient longer lasting pain relief. This procedure is an actual surgery including an incision and a period of recovery from the surgery.

How is a Sacroiliac Joint Radiofrequency Rhizotomy done?

Here are some of the steps in performing this procedure:

  1. Usually an intravenous catheter is placed and some relaxing medication given to the patient.
  2. This procedure is typically performed in a Procedure Room or Operating Room.
  3. The patient is placed on the stomach (prone).
  4. The skin of the low back is cleaned with a sterile antiseptic solution and sheets (drapes) are placed around it.
  5. The skin is anesthetized with local anesthetic.
  6. An X-Ray machine is used to find the joint.
  7. Specialized needles (radiofrequency needles) are placed next to the joint at multiple places.
  8. The specialized needles are hooked up to a radiofrequency generator (machine which generates radiofrequency energy).
  9. The radiofrequency generator is turned to a certain frequency which sends impulses to the nerve. This stimulates the nerve and gives the patient a similar sensation than their usual symptoms. This may be felt as slight pain, tingling, or pressure.
  10. Next, the radiofrequency generator is turned to a different frequency. On this frequency, the larger nerves which give you movement (motor) are tested. The doctor does not want the specialized needle (radiofrequency needle) to be too close to these nerves.
  11. Now, the radiofrequency generator is turned to a setting where it can deliver a very targeted radiofrequency energy in the form of heat. The doctor choses the temperature, and the time interval for how long this temperature is delivered to the nerve. Just prior to delivering the heat energy, the doctor often injects a local anesthetic onto the nerve to lessen any discomfort.
  12. Once all the nerves are treated in this fashion, the needles are withdrawn.
  13. Sterile band-aids are place.
  14. The patient is turned on the back and taken to the Recovery Room.

How long does it take to perform a Sacroliliac Joint Radiofrequency Rhizotomy?

This procedure may take about 15 to 30 minutes or more to complete.

What type of benefit can patients gain from a Sacroiliac Joint Radiofrequency Rhizotomy?

Pain relief from this procedure can vary. For patients who respond well, pain is often relieved for up to 6 months.