Short- and long-term outcomes of cooled radiofrequency ablation for SI joint–mediated low back pain: a prospective study of 153 patients using multidimensional patient-reported measures

Sacroiliac joint-mediated low back pain is a common cause of disability. Cooled radiofrequency ablation (CRFA) targets the lateral branch nerves innervating the sacroiliac joint, with enhanced lesioning capability and growing clinical use. To evaluate short- and long-term outcomes following CRFA using multiple patient-reported outcome measures. This prospective cohort study included 153 patients with chronic SI joint–related low back pain treated with CRFA. Pain and function were assessed using the Visual Analogue Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), Roland–Morris Disability Questionnaire (RMDQ), EQ-5D-5L index, and EQ-5D-5L health VAS at baseline, 6 weeks, 3 months, 6 months, and 1-year post-procedure. The VAS back pain score decreased from 6.72 ± 2.59 at baseline to 5.36 ± 2.10 at 6 weeks ( p < 0.01) and 4.54 ± 2.30 at 1 year ( p < 0.001). VAS leg pain improved from 6.22 ± 3.03 to 4.02 ± 3.06 at 6 weeks and 3.54 ± 3.18 at 1 year (both p < 0.001). Functional outcomes improved significantly, with ODI decreasing from 48.8 ± 16.9 to 37.7 ± 15.4 at 6 months and 37.2 ± 22.0 at 1 year (both p < 0.05). RMDQ score improved from 13.69 ± 5.99 at baseline to 10.06 ± 5.93 at 6 weeks ( p < 0.01) and 8.9 ± 4.8 at 1 year ( p < 0.01). EQ-5D-5L health status VAS scores, which increased significantly from 50.25 ± 21.67 at baseline to 67.15 ± 20.88 at 1-year post-procedure ( p < 0.01). On the EQ-5D-5L, based on available domain-level responses, the Pain/Discomfort domain showed the most pronounced improvement, with mean scores decreasing from 3.61 ± 0.79 at baseline to 3.05 ± 0.85 at 6 weeks, 2.67 ± 0.65 at 3 months, and 2.86 ± 0.95 at 1 year. The Usual Activities domain also improved from 3.28 ± 1.07 at baseline to 2.66 ± 1.08 at 1 year. CRFA demonstrated a favorable safety profile, with no serious procedure-related complications observed, while being associated with clinically meaningful improvements in pain, function, and health-related quality of life, supporting its role as a promising minimally invasive treatment for well-selected patients with SI joint–mediated pain.