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Novel Single Puncture Approach for Simplicity 3 Sacral Plexus Radiofrequency Ablation: Technical Note.

Christopher J Gilligan, Jennifer C Shih¹, Viet L Cai²

¹Massachusetts General Hospital, Department of Radiology, Boston, MA.

|May 27, 2016

Summary

A modified Seldinger technique for radiofrequency ablation of the sacral plexus offers a safer, single-puncture alternative for treating sacroiliac joint pain. This image-guided approach reduces complications and procedure time.

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Area of Science:

Pain Management
Interventional Radiology
Neuromodulation

Background:

Sacroiliac joint pain, often due to osseous metastasis, is treated with radiofrequency (RF) ablation of the sacral plexus.
Current techniques using the Simplicity III system involve multiple needle passes, increasing complication risks like bowel perforation and radiation exposure.

Observation:

A modified Seldinger approach was employed for RF ablation of the dorsal sacral plexus using the Simplicity III system.
This technique involves initial anesthesia via a micropuncture needle, followed by sheath placement and RF probe insertion through the sheath.

Findings:

The modified Seldinger approach allows precise probe placement along a single anesthetized tract.
This single percutaneous puncture technique potentially reduces procedure time, radiation dose, and risks of complications compared to standard methods.

Implications:

This modified technique offers a potentially safer and more efficient method for radiofrequency ablation of the sacral plexus.
It may improve outcomes for patients with chronic sacral pain, particularly those with osseous metastases.