Radiofrequency ablation of the sacral lateral branches

The objective of this article is to recommend an approach to radiofrequency ablation (RFA) of the sacral lateral branches that is safe, effective, and simple to perform. To do so, one must identify the proper patient, perform a diagnostic block to confirm the sacroiliac joint as the pain generator, and then, after 2 successful blocks, move to RFA of the sacral lateral branches as the next step in treatment. The choice of an RFA technique is controversial. Here, an argument is made for moving to bipolar RFA of the lateral branches of S1-S3. If pain is refractory, then cooled RFA may be an appropriate next step in care.