Cooled radiofrequency ablation provides extended clinical utility in the management of chronic sacroiliac joint pain: 12-month follow-up results from the observational phase of a randomized, multicenter, comparative-effectiveness crossover study.

Study Summary

210 patients with chronic sacroiliac joint (SIJ) pain were randomized to receive cooled radiofrequency ablation (CRFA) or standard medical management (SMM), with patients experiencing unsatisfactory outcomes following SMM permitted to cross over to CRFA after 3 months. The primary outcome was the change in average low back pain intensity measured using the Numeric Rating Scale (NRS). Secondary outcomes included the Oswestry Disability Index (ODI), EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire, 36-Item Short Form Health Survey (SF-36), and Patient Global Impression of Change (PGIC). Outcomes were assessed at 1, 3, 6, 9, and 12 months following CRFA. Overall, the results revealed that CRFA significantly reduced pain and improved physical function and quality of life over 12 months, with similar improvements among patients who initially received CRFA and those who crossed over from SMM. These findings suggested that a single CRFA procedure provided sustained clinical benefits for selected patients with chronic SIJ pain, although the absence of a long-term medical management control group limited comparative conclusions beyond 3 months.