Abstract
Introduction
Percutaneous radiofrequency lesioning of the lateral branches of the sacroiliac joint has become a recognised method of treating chronic pain arising from this joint. Due to the large and varied innervation from the S1-3 lateral branches success has been achieved with large lesions that has a high chance of covering these nerves. Such lesions require specialised and expensive equipment and the NIMBUS needle is a large 17G electrode with expandable tines at the tip. It is compatible with all standard radiofrequency probes and it produces a large lesion at the tip. It has been in use in the USA in over 100 cases and we describe its use in the UK
Methods
Patients were identified as having sacroiliac joint pain by clinical assessment and positive pain response to local anaesthetic sacroiliac joint lateral branch blocks.
Under fluoroscopic control, the needle is inserted at the lateral edge of the sacral S1-3 posterior foramen. Three lesions at the lateral edge of the foramen are made at 80°C for 90s. A further lesion is made at the L5 dorsal ramus.
Results
4 patients achieved very good pain relief >50% reduction in pain scores on the NRS scale at 6 weeks follow up. No complications were noted and there were no technical difficulties.
Conclusion
Lesioning with the NIMBUS needle is feasible and allows clinicians a method of treating chronic sacroiliac joint pain using existing radiofrequency equipment. Further large, long term studies are warranted to establish clinical efficacy.
