Cryoneurolysis of Sacral Lateral Branches for Chronic Sacroiliac Joint Pain: A Multicenter Retrospective Cohort Study

BACKGROUND Chronic sacroiliac joint (SIJ) pain is a common cause of chronic low back pain and disability. Cryoneurolysis targeting the sacral lateral branches has emerged as a minimally invasive treatment option for SIJ-mediated pain. MATERIAL AND METHODS This multicenter retrospective cohort study included 107 patients with chronic SIJ-mediated pain confirmed by a diagnostic SIJ block that achieved at least 50% pain relief. All patients underwent cryoneurolysis of the lateral branches of the L5 and S1 to S3 dorsal rami. Pain intensity was assessed using the Numeric Rating Scale (NRS) and Visual Analog Scale (VAS); functional disability was evaluated using the Oswestry Disability Index (ODI). Outcomes were analyzed at baseline and at 3 and 6 months post-procedure. RESULTS Significant reductions in pain intensity were observed at both follow-up time points (P<0.001). Mean NRS scores decreased from 7.4±1.1 at baseline to 3.6±1.5 at 3 months and 4.2±1.7 at 6 months. Mean VAS scores decreased from 74±12 mm at baseline to 38±15 mm and 45±17 mm, respectively. Mean ODI scores improved from 42±9% at baseline to 24±10% at 3 months and 28±11% at 6 months. At least 50% pain reduction was achieved in 59.8% of patients at 3 months and 48.6% at 6 months. No serious adverse events were observed. CONCLUSIONS Cryoneurolysis offers a safe and potentially effective minimally invasive treatment for chronic SIJ-mediated pain, providing short- to mid-term pain relief and functional improvement.