Outcomes of Percutaneous Zygapophysial and Sacroiliac Joint Neurotomy in a Community Setting


Geoffrey C. Speldewinde, FAFRM(RACP), FFPMANZCA, Capital Rehabilitation and Pain Management Centre, 25 Napier Close, Deakin, Canberra ACT, Australia. Tel: +612-6282-6240; Fax: +612-6282-5510; E-mail: gspeld@capitalrehab.com.au.


Objective.  To evaluate the analgesic, physical, and psychological outcomes of percutaneous radiofrequency neurotomy for persistent zygapophysial and sacroiliac joint pain in a community setting.

Design.  A prospective evaluation of 379 consecutive neurotomies in a single specialist practice over an extended period 2001–2010.

Setting.  A provincial community environment in Australia.

Patients.  All patients who had positive responses to diagnostic blocks, performed according to the guidelines of the International Spine Intervention Society by three trained specialists, underwent percutaneous radiofrequency thermal neurotomies performed by the author.

Interventions.  Radiofrequency neurotomies to denervate the zygapophysial or sacroiliac joints according to the standards of the International Spine Intervention Society.

Outcome Measures.  Numerical Rating Scale for Pain, Functional Rating Index, 4-Activities of Daily Living Scale, General Health Questionnaire, Depression Anxiety Stress Scale, duration of pain relief, “whether they would do it again,” and overall amount of pain relief.

Results.  Of 379 procedures, 272 (72%) were regarded as successful by the patients. Irrespective of region treated. The results were highly significant by t-test, and the effect size was large as determined by the Cohen's d. Adverse events were infrequent and relatively minor. Repetitions of the procedure were highly successful.

Conclusions.  Neurotomy of the cervical, thoracic, lumbar, and sacroiliac joints were uniformly successful with 72% recipients obtaining an average of 86% reduction in pain for a period of 12 months.