Background:
Sacroiliac Joint (SIJ) dysfunction is a frequent source of chronic low back pain, particularly in patients with prior lumbar fusion. Cooled radiofrequency ablation (CRFA) has emerged as an effective, minimally invasive intervention. However, limited evidence exists regarding its long-term outcomes, including progression to spinal fusion and repeat procedure rates.
Methods:
Following institutional review board approval, we retrospectively reviewed 170 patients (109 females, 61 males; mean age 56.8 ± 16.6) who underwent CRFA by a single surgeon between June 2020 and May 2025. Clinical data were analyzed for pain scores, functional outcomes, fusion conversion, and reintervention. A subgroup of 45 patients had previous lumbar fusion. The minimum follow-up period was 6 months, extending up to 12 months.
Results:
Significant improvements were observed in Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) at 3, 6, and 12 months postoperatively (p < 0.01). Roland-Morris Questionnaire (RMQ) scores improved at 3 months (p < 0.01), but not at later follow-up. Of the cohort, 28 patients (16.5%) progressed to spinal fusion, while 17 (10.0%) underwent repeat CRFA. Subgroup analysis demonstrated comparable outcomes in patients with and without prior lumbar fusion.
Conclusion:
This large single-surgeon cohort highlights the real-world efficacy of CRFA in managing SI joint pain, with durable pain relief, low reintervention rates, and a potential role in delaying or reducing the need for spinal fusion. CRFA may serve as a bridge between conservative and surgical treatments for SI joint dysfunction.