Predictive Factors, Efficiency, and Outcomes of Radiofrequency Ablative Therapy for Sacroiliac Joint Syndrome: A Retrospective Study

Introduction: The sacroiliac joint (SIJ), despite limited mobility, plays a crucial role in load transfer and pelvic stability. As a true diarthrodial joint, it accounts for 15%–38% of low back pain cases. This study evaluated the clinical outcomes of radiofrequency ablation (RFA) for SIJ syndrome and examined predictors of treatment response. Methods: We retrospectively analyzed 101 patients treated with intra‐articular RFA between 2017 and 2020. Pain and function were assessed using the Visual Analog Scale (VAS), Oswestry disability index (ODI), and McNab criteria. Results: The cohort (53.5% female, mean age 69.0 ± 14.2 years, BMI 28.18 ± 4.87) showed significant improvements in pain (VAS: 7.68 ± 1.4 to 2.6 ± 1.54 at 24 h, p < 0.001) and function (ODI: 57.5 ± 17.5 to 37.9 ± 16.97 at 12 months, p < 0.001). McNab scores improved from 2.36 ± 1.03 at 6 weeks to 3.32 ± 0.88 at 12 months ( p < 0.001). Higher BMI was strongly associated with poorer outcomes (VAS r = 0.433–0.719, ODI r = 0.990, McNab r = –0.960 to –0.914; all p < 0.001). Prior spinal surgery affected short‐term recovery but not long‐term results. Conclusion: Intra‐articular RFA is an effective treatment for SIJ syndrome, offering sustained pain relief and functional improvement up to 12 months. High BMI negatively impacts outcomes, highlighting the value of adjunctive strategies like weight management and rehabilitation to enhance long‐term success.