Complications of sacroiliac joint block and ablation

While the lumbar spine, in particular, is the region of the spine where pain is commonly experienced, the sacroiliac joint (SIJ) is the underlying cause of chronic low back pain in 15-0% of patients with this complaint. This pathologic underpinning is especially true for patients with a history of trauma, lumbosacral fusion, and spondyloarthropathy. There are several approaches to the SIJ for injection or denervation. The choice of technique is typically based on provider preference, proficiency, or resources available. The techniques include landmark approach, fluoroscopically-guided approach, CT-guided approach and ultrasound. In contrast, SIJ denervation with conventional radiofrequency ablation is associated with a higher incidence of both procedural- and post-procedural pain. Procedural pain associated with SIJ injection is primarily experienced during the creation of the skin wheel of local anesthetic, and then during the injection of the therapeutic into the joint space itself.