ĐIỀU TRỊ ĐAU KHỚP CÙNG CHẬU SAU PHẪU THUẬT TRƯỢT ĐỐT SỐNG THẮT LƯNG-CÙNG BẰNG SÓNG CAO TẦN DƯỚI HƯỚNG DẪN SIÊU ÂM

Abstract

Background: Sacroiliac joint pain is the most common cause of low back pain, especially in patients with L5 and S1 spinal fixation surgery. Our study evaluated the clinical feasibility of ultrasound-guided lateral branch radiofrequencya blation for sacroiliac joint (SIJ) pain after lumbosacral spinal fusion surgery (LSFS). Materials and methods: This prospective study included a total of 46 patients who were diagnosed with SIJ pain after LSFS, did not respond to conservative treatment and therefore underwent ultrasound-guided SIJ radiofrequency ablation (RFA) from Jan 2019 to Jan 2022, at Department of Neurosurgery, University Medical Center in Ho Chi Minh City. Results: Forty-six patients met the criteria for sacroiliac pain after lumbosacral spondylolisthesis surgery. The mean age was 51.7 ± 15.3 years old and most of the patients were male (32 male, 14 female). Before the procedure, pain was assessed by NRS and ODI (30.4% of patients cripple). The NRS score one week after the procedure was significantly lower than before the injection on admission. The NRS at the one-month, six-month and twelve-month follow-up visits showed a decrease compared with the pre-intervention NRS (p<0.001). Patients treated with radiofrequency waves had significantly lower ODI scores at 1, 3, and 6 months compared with pre-intervention. The change in ODI before and after the intervention at 1, 3 and 6 months was statistically significant (p<0.001). No serious adverse events or deaths were recorded. Conlusion: Application of ultrasound-guided radiofrequency ablation of the median branch nerve at the sacral foramen in the treatment of chronic sacroiliac pain after lumbar spondylolisthesis surgery is an initial method showing its effectiveness and safety. In addition to the limited series reported in the literature, future studies will add meaning to this topic by including it in routine practice.