Ablation of Si joint under spinal endoscopy

The diagnosis of chronic low back pain secondary to dysfunction of the sacroiliac joint is a challenge for the spine surgeon and interventional pain specialist. The sacroiliac joint is an anatomical structure with an important function in the distribution of loads from the spine to the legs and vice versa. It also has a complex nerve network that gives it sensitivity and which is formed mainly by the lateral branches of the dorsal sacral ramus from S1 to S3 with the inconstant participation of L5 and S4. The treatment of the pain syndrome caused by this joint is equally complicated. Within the current options, there are intra-articular and periarticular injections, radiofrequency ablation, and, in selected cases, the fusion of the joint. This chapter presents the endoscopic-assisted radiofrequency ablation technique for sacroiliac joint pain. Also, the topographic anatomy, diagnosis of articular dysfunction, and current treatments are discussed for the correct understanding of the endoscopic technique.