Chronic sacroiliac joint (SIJ) pain is a frequent contributor to chronic low back pain and related disability. Minimally invasive neuroablative techniques have been sought to reduce pain originating from the SIJ when conservative measures fail. Cryoneurolysis, applied to sensory nerve branches, has emerged as a treatment option intended to interrupt nociceptive signaling by producing a temporary axonotmesis while preserving surrounding structures. This study assessed cryoneurolysis targeted to sacral lateral branches as a therapeutic approach for patients with SIJ-mediated pain confirmed by diagnostic block.
This was a multicenter retrospective cohort study including 107 patients. Inclusion required chronic SIJ-mediated pain confirmed by a diagnostic SIJ block that produced at least 50% pain relief. The cohort and study were analyzed retrospectively across multiple centers; the abstract does not provide further granular details on additional inclusion/exclusion criteria, baseline comorbidities, concurrent treatments, or specific center-level protocols.
All patients underwent cryoneurolysis directed at the lateral branches of the L5 dorsal ramus and the S1 to S3 dorsal rami. The abstract reports the targeted nerve levels but does not detail procedural technique, device specifications, imaging guidance, number or duration of freeze cycles, or peri-procedural medications. These procedural specifics were not reported in the abstract.
Pain intensity and functional disability were prospectively assessed at baseline and at 3 and 6 months after the procedure using validated metrics. Pain was quantified with the Numeric Rating Scale (NRS) and the Visual Analog Scale (VAS). Functional disability was assessed with the Oswestry Disability Index (ODI). The primary analytic comparisons reported in the abstract focused on changes from baseline to 3 months and to 6 months.
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 at 3 months and 45 ± 17 mm at 6 months. These results indicate a substantial reduction in reported pain intensity at 3 months with partial maintenance at 6 months.
Functional disability, measured by the Oswestry Disability Index (ODI), improved after treatment. Mean ODI scores were 42 ± 9% at baseline, improving to 24 ± 10% at 3 months and 28 ± 11% at 6 months. These changes suggest clinically meaningful improvement in function and disability at the cohort level, particularly at the 3-month assessment.
Responder analysis reported the proportion of patients achieving at least 50% pain reduction. At 3 months, 59.8% of patients achieved this threshold. At 6 months, 48.6% of patients maintained at least 50% pain reduction. These figures indicate that a majority of patients experienced substantial pain relief at 3 months, with a decline in the responder proportion by 6 months, suggesting partial waning of effect in some patients within the mid-term follow-up window.
No serious adverse events were observed in the cohort as reported in the abstract. The publication lists no serious complications attributable to the cryoneurolysis procedures; however, the abstract does not enumerate minor or transient adverse events, infection rates, neurological sequelae, or other safety details that may be present in the full text.
As reported in the abstract, this is a retrospective study, which limits causal inference and is subject to selection and information biases. Several important details were not provided in the abstract, including:
These omissions limit interpretation of generalizability and operational reproducibility from the abstract alone.
In this multicenter retrospective cohort of 107 patients with diagnostic-block–confirmed SIJ-mediated pain, cryoneurolysis of the lateral branches of L5 and S1–S3 dorsal rami was associated with statistically significant reductions in pain (NRS and VAS) and improvements in function (ODI) at 3 and 6 months. A 50% or greater pain reduction was achieved in about 60% of patients at 3 months and in about 49% at 6 months. No serious adverse events were reported in the abstract. The findings support cryoneurolysis as a safe, minimally invasive option that can provide short- to mid-term pain relief and functional benefit for selected patients with chronic SIJ-mediated pain. The retrospective design and limited procedural and adverse-event detail in the abstract underscore the need to consult the full text for methodology, comprehensive safety data, and longer-term outcomes or to await prospective controlled trials for stronger comparative evidence.