Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 2;4(2):100599.
doi: 10.1016/j.inpm.2025.100599. eCollection 2025 Jun.

What is the optimal block selection paradigm for predicting a successful treatment outcome following sacral lateral branch radiofrequency neurotomy? A real-world cohort study

Katharine A Smolinski  1 , Christopher Radlicz  2 , Hasan Sen  1 , Amanda N Cooper  1 , Brook Martin  3 , Alycia Amatto  4 , Allison Glinka Przybysz  1 , Robert Burnham  4   5   6 , Aaron M Conger  1 , Zachary L McCormick  1 , Taylor R Burnham  1   6
Affiliations

What is the optimal block selection paradigm for predicting a successful treatment outcome following sacral lateral branch radiofrequency neurotomy? A real-world cohort study

Katharine A Smolinski et al. Interv Pain Med. .

Abstract

Background: Outcomes following sacral lateral branch radiofrequency neurotomy (SLBRFN) likely depend on patient selection criteria; however, commonly used criteria vary considerably. Refinement of selection criteria for SLBRFN may improve treatment outcomes. This study investigated common prognostic block-based selection criteria and treatment success following SLBRFN.

Methods: In this retrospective cohort study, consecutive patients from two Canadian musculoskeletal pain management clinics who underwent SLBRFN over a 6-year period (2016-2022) were identified by electronic medical record. Patients were categorized according to several prognostic block paradigms based on number of blocks (single vs. dual), block type (lateral branch block [LBB] vs. intra-articular block [IAB]), and subsequent percentage of pain relief. Six block criteria were established: 1 = LBB/LBB≥80 %; 2 = IAB/LBB≥80 %; 3 = LBB/LBB 50-79 %; 4 = IAB/LBB 50-79 %; 5 = LBB≥80 %; 6 = LBB 50-79 %. Treatment success was assessed at three months post-SLBRFN using two criteria: (1) the primary study outcome of ≥50 % numerical rating scale (NRS) pain reduction and (2) a secondary outcome of Pain Disability Quality-of-Life Questionnaire (PDQQ) score improvement by the minimal clinically important difference (MCID). Logistic regression analyses evaluated the association between block criteria and treatment success following SLBRFN.

Results: 281 consecutive patients (75.1 % female, 61.8 ± 14.2 years of age, BMI 29.4 ± 6.6 kg/m2) were included. Cohort success rates for pain and functional improvement were 43.4 % (95 % CI: 37.8-49.3) and 46.6 % (95 % CI: 40.9-52.5), respectively. After adjusting for demographics and cannula type/SLBRFN technique, none of the odds ratios for the six prognostic block paradigms showed statistical significance.

Conclusion: Nearly 50 % of patients who underwent SLBRFN reported clinically significant improvement in pain and disability at three months post-procedure, regardless of prognostic block selection criteria. These results suggest that multiple block strategies may determine eligibility for SLBRFN.

Keywords: Radiofrequency ablation; Radiofrequency neurotomy; Sacral lateral branch; Sacroiliac joint pain.

PubMed Disclaimer

Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Zachary L. McCormick reports a relationship with International Pain & Spine Intervention Society that includes: board membership. Zachary L. McCormick reports a relationship with Avanos Medical Inc that includes: consulting or advisory and funding grants. Zachary L. McCormick reports a relationship with Boston Scientific Corporation that includes: funding grants. Zachary L. McCormick reports a relationship with Saol Therapeutics that includes: consulting or advisory and funding grants. Zachary L. McCormick reports a relationship with Spine Biopharma that includes: funding grants. Zachary L. McCormick reports a relationship with SPR Therapeutics Inc that includes: funding grants. Zachary L. McCormick reports a relationship with Stratus Medical that includes: funding grants. Zachary L. McCormick reports a relationship with Stryker that includes: consulting or advisory. Taylor R Burnham reports a relationship with Diros Technology Inc that includes: funding grants. Taylor R Burnham reports a relationship with Avanos Medical Inc that includes: consulting or advisory. Aaron M Conger reports a relationship with Stratus that includes: funding grants. Robert Burnham reports a relationship with International Pain & Spine Intervention Society that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Similar articles

See all similar articles

References

    1. Lee D.W., Cheney C., Sherwood D., Wahezi S., Monteiro P., McCormick Z.L., Conger A., Duszynski B., Smith C.C. The effectiveness and safety of sacral lateral branch radiofrequency neurotomy (SLBRFN): a systematic review. Interv Pain Med. 2023;2(2) doi: 10.1016/j.inpm.2023.100259. - DOI - PMC - PubMed
    1. Yang A.J., Wagner G., Burnham T., McCormick Z.L., Schneider B.J. Radiofrequency ablation for chronic posterior sacroiliac joint complex pain: a comprehensive review. Pain Med. 2021;22(Suppl 1):S9–S13. doi: 10.1093/pm/pnab021. - DOI - PubMed
    1. Yang A.J., McCormick Z.L., Zheng P.Z., Schneider B.J. Radiofrequency ablation for posterior sacroiliac joint complex pain: a narrative review. Pharm Manag PM&R. 2019;11(Suppl 1):S105–S113. doi: 10.1002/pmrj.12200. - DOI - PubMed
    1. Loh E., Burnham T., Burnham R. Sacroiliac joint diagnostic block and radiofrequency ablation techniques. Phys Med Rehabil Clin. 2021;32(4):725–744. - PubMed
    1. Schneider B.J., Rosati R., Zheng P., McCormick Z.L. Challenges in diagnosing sacroiliac joint pain: a narrative review. Pharm Manag PM R. 2019;11(Suppl 1):S40–S45. doi: 10.1002/pmrj.12175. - DOI - PubMed

LinkOut - more resources