scholarly journals Characteristics of the spinopelvic parameters of patients with sacroiliac joint pain

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juichi Tonosu ◽  
Hiroyuki Oka ◽  
Kenichi Watanabe ◽  
Hiroaki Abe ◽  
Akiro Higashikawa ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Pelvic Incidence ◽  
Demographic Characteristics ◽  
Sacral Slope ◽  
Low Back ◽  
Spinopelvic Parameters ◽  
Sacroiliac Joint Pain ◽  
Physical Findings ◽  
Univariate Analyses

AbstractTo evaluate the characteristics of the spinopelvic parameters on radiography in patients with sacroiliac joint pain (SIJP). Two hundred fifty patients were included and divided into the SIJP group (those diagnosed with SIJP based on physical findings and response to analgesic periarticular injections; n = 53) and the non-SIJP group (those with low back pain [LBP] because of other reasons; n = 197). We compared their demographic characteristics and spinopelvic parameters using radiography. All differences found in the patients’ demographic characteristics and spinopelvic parameters were analyzed. More female participants experienced SIJP than male participants (P = 0.0179). Univariate analyses revealed significant differences in pelvic incidence (PI) (P = 0.0122), sacral slope (SS) (P = 0.0034), and lumbar lordosis (LL) (P = 0.0078) between the groups. The detection powers for PI, SS, and LL were 0.71, 0.84, and 0.66, respectively. Logistic regression analyses, after adjustment for age and sex, revealed significant differences in PI (P = 0.0308) and SS (P = 0.0153) between the groups, with odds ratios of 1.03 and 1.05, respectively. More female participants experienced SIJP than male participants. Higher PI and SS values were related to SIJP among LBP patients.

scholarly journals Low back pain: Sacroiliac joint pain may be myth

BMJ ◽  
2004 ◽  
Vol 329 (7459) ◽  
pp. 232.1 ◽  
Author(s):  
Andrew N Bamji
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Low Back ◽  
Sacroiliac Joint Pain

scholarly journals Evaluation of Sacroiliac Joint Interventions: A Systematic Appraisal of the Literature

2009 ◽  
Vol 2;12 (2;3) ◽  
pp. 399-418 ◽  
Author(s):  
Matthew P. Rupert
Keyword(s):  
Local Anesthetic ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Therapeutic Interventions ◽  
Low Back ◽  
Level Of Evidence ◽  
Sacroiliac Joint Pain ◽  
Radiofrequency Neurotomy ◽  
Methodologic Quality ◽  
Level Ii

Background: The sacroiliac joint has been implicated as a source of low back and lower extremity pain. There are no definite historical, physical, or radiological features that can definitively establish a diagnosis of sacroiliac joint pain. Based on the present knowledge, an accurate diagnosis is made only by controlled sacroiliac joint diagnostic blocks. The sacroiliac joint has been shown to be a source of pain in 10% to 27% of suspected patients with chronic low back pain utilizing controlled comparative local anesthetic blocks. Study Design: A systematic review of diagnostic and therapeutic sacroiliac joint interventions. Objective: To evaluate the accuracy of diagnostic sacroiliac joint interventions and the utility of therapeutic sacroiliac joint interventions. Methods: The literature search was carried out by searching the databases of PubMed, EMBASE, and Cochrane reviews. Methodologic quality assessment of included studies was performed using the Agency for Healthcare Research and Quality (AHRQ) methodologic quality criteria for diagnostic accuracy and observational studies, whereas randomized trials were evaluated utilizing the Cochrane review criteria. Only studies with scores of 50 or higher were included for assessment. Level of evidence was based on the U.S. Preventive Services Task Force (USPSTF) criteria. Outcome Measures: For diagnostic interventions, the outcome criteria included at least 50% pain relief coupled with a patient’s ability to perform previously painful maneuvers with sustained relief using placebo-controlled or comparative local anesthetic blocks. For therapeutic purposes, outcomes included significant pain relief and improvement in function and other parameters. Short-term relief for therapeutic interventions was defined as 6 months or less, whereas long-term effectiveness was defined as greater than 6 months. Results: The indicated level of evidence is II-2 for the diagnosis of sacroiliac joint pain utilizing comparative, controlled local anesthetic blocks. The prevalence of sacroiliac joint pain is estimated to range between 10% and 38% using a double block paradigm in the study population. The false-positive rate of single, uncontrolled, sacroiliac joint injections is 20% to 54%. The evidence for provocative testing to diagnose sacroiliac joint pain is Level II-3 or limited. For radiofrequency neurotomy the indicated evidence is limited (Level II-3) for short- and longterm relief. Limitations: The limitations of this systematic review include the paucity of literature evaluating the role of both diagnostic and therapeutic interventions and widespread methodological flaws. Conclusions: The indicated evidence for the validity of diagnostic sacroiliac joint injections is Level II-2. The evidence for the accuracy of provocative maneuvers in the diagnosing of sacroiliac joint pain is limited (Level II-3). The evidence for radiofrequency neurotomy is also limited (Level II-3). Key words: Chronic low back pain, sacroiliac joint pain, sacroiliitis, sacroiliac joint injection, sacroiliac joint dysfunction, thermal radiofrequency, pulsed radiofrequency

scholarly journals Sacroiliac Joint Interventions: A Systematic Review

2007 ◽  
Vol 1;10 (1;1) ◽  
pp. 165-184
Author(s):  
Hans C. Hansen
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Local Anesthetic ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Low Back ◽  
Sacroiliac Joint Pain ◽  
Radiofrequency Neurotomy ◽  
Joint Injections

Background: The sacroiliac joint is a diarthrodial synovial joint with abundant innervation and capability of being a source of low back pain and referred pain in the lower extremity. There are no definite historical, physical, or radiological features to provide definite diagnosis of sacroiliac joint pain, although many authors have advocated provocational maneuvers to suggest sacroiliac joint as a pain generator. An accurate diagnosis is made by controlled sacroiliac joint diagnostic blocks. The sacroiliac joint has been shown to be a source of pain in 10% to 27% of suspected cases with chronic low back pain utilizing controlled comparative local anesthetic blocks. Intraarticular injections, and radiofrequency neurotomy have been described as therapeutic measures. This systematic review was performed to assess diagnostic testing (non-invasive versus interventional diagnostic techniques) and to evaluate the clinical usefulness of interventional techniques in the management of chronic sacroiliac joint pain. Objective: To evaluate and update the available evidence regarding diagnostic and therapeutic sacroiliac joint interventions in the management of sacroiliac joint pain. Study Design: A systematic review using the criteria as outlined by the Agency for Healthcare Research and Quality (AHRQ), Cochrane Review Group Criteria for therapeutic interventions and AHRQ, and Quality Assessment for Diagnostic Accuracy Studies (QUADAS) for diagnostic studies. Methods: The databases of EMBASE and MEDLINE (1966 to December 2006), and Cochrane Reviews were searched. The searches included systematic reviews, narrative reviews, prospective and retrospective studies, and cross-references from articles reviewed. The search strategy included sacroiliac joint pain and dysfunction, sacroiliac joint injections, interventions, and radiofrequency. Results: The results of this systematic evaluation revealed that for diagnostic purposes, there is moderate evidence showing the accuracy of comparative, controlled local anesthetic blocks. Prevalence of sacroiliac joint pain is estimated to range between 10% and 27% using a double block paradigm. The false-positive rate of single, uncontrolled, sacroiliac joint injections is around 20%. The evidence for provocative testing to diagnose sacroiliac joint pain is limited. For therapeutic purposes, intraarticular sacroiliac joint injections with steroid and radiofrequency neurotomy were evaluated. Based on this review, there is limited evidence for short-term and longterm relief with intraarticular sacroiliac joint injections and radiofrequency thermoneurolysis. Conclusions: The evidence for the specificity and validity of diagnostic sacroiliac joint injections is moderate. The evidence for accuracy of provocative maneuvers in diagnosis of sacroiliac joint pain is limited. The evidence for therapeutic intraarticular sacroiliac joint injections is limited. The evidence for radiofrequency neurotomy in managing chronic sacroiliac joint pain is limited. Keywords: Low back pain, sacroiliac joint pain, axial pain, spinal pain, diagnostic block, sacroiliac joint injection, thermal radiofrequency, and pulsed radiofrequency

Audit of Conservative Management of Chronic Low Back Pain in a Secondary Care Setting – Part I: Facet Joint and Sacroiliac Joint Interventions

2004 ◽  
Vol 22 (4) ◽  
pp. 207-213 ◽  
Author(s):  
Robin Chakraverty ◽  
Richard Dias
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Conservative Management ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Facet Joint ◽  
Low Back ◽  
Sacroiliac Joint Pain ◽  
Radiofrequency Denervation ◽  
Facet Joint Pain

The work of a chronic back pain service in secondary care in the West Midlands is reported. The service offers acupuncture, spinal injection procedures, osteopathy and a range of other interventions for patients whose back pain has not responded to conservative management. This section of the report focuses on injection procedures for lumbar facet joint and sacroiliac joint pain, which have been shown to be the cause of chronic low back pain in 16–40% and 13–19% of patients respectively. Diagnosis relies on the use of intra-articular or sensory nerve block injections with local anaesthetic. Possible treatments following diagnosis include intra-articular corticosteroid, radiofrequency denervation (for facet joint pain) or ligament prolotherapy injections (for sacroiliac joint pain). The results of several hospital audits are reported. At six month follow up, 50% of 38 patients undergoing radiofrequency denervation following diagnostic blocks for facet joint pain had improved by more than 50%, compared to 29% of 34 patients treated with intra-articular corticosteroid injection. Sixty three per cent of 19 patients undergoing prolotherapy following diagnostic block injection for sacroiliac joint pain had improved at six months, compared to 33% of 33 who had intra-articular corticosteroid. Both radiofrequency denervation and sacroiliac prolotherapy showed good long-term outcomes at one year.

scholarly journals A Systematic Evaluation of Prevalence and Diagnostic Accuracy of Sacroiliac Joint Interventions

2012 ◽  
Vol 3;15 (3;5) ◽  
pp. E305-E344 ◽  
Author(s):  
Thomas T. Simopoulos
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Accuracy ◽  
Local Anesthetic ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
The United States ◽  
Low Back ◽  
Sacroiliac Joint Pain

Background: The contributions of the sacroiliac joint to low back and lower extremity pain have been a subject of considerable debate and research. It is generally accepted that 10% to 25% of patients with persistent mechanical low back pain below L5 have pain secondary to sacroiliac joint pathology. However, no single historical, physical exam, or radiological feature can definitively establish a diagnosis of sacroiliac joint pain. Based on present knowledge, a proper diagnosis can only be made using controlled diagnostic blocks. The diagnosis and treatment of sacroiliac joint pain continue to be characterized by wide variability and a paucity of the literature. Objective: To evaluate the accuracy of diagnostic sacroiliac joint interventions. Study Design: A systematic review of diagnostic sacroiliac joint interventions. Methods: Methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, or limited (or poor) based on the quality of evidence developed by the United States Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to December 2011, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: In this evaluation we utilized controlled local anesthetic blocks using at least 50% pain relief as the reference standard. Results: The evidence is good for the diagnosis of sacroiliac joint pain utilizing controlled comparative local anesthetic blocks. The prevalence of sacroiliac joint pain is estimated to range between 10% and 62% based on the setting; however, the majority of analyzed studies suggest a point prevalence of around 25%, with a false-positive rate for uncontrolled blocks of approximately 20%. The evidence for provocative testing to diagnose sacroiliac joint pain was fair. The evidence for the diagnostic accuracy of imaging is limited. Limitations: The limitations of this systematic review include a paucity of literature, variations in technique, and variable criterion standards for the diagnosis of sacroiliac joint pain. Conclusions: Based on this systematic review, the evidence for the diagnostic accuracy of sacroiliac joint injections is good, the evidence for provocation maneuvers is fair, and evidence for imaging is limited. Key words: Chronic low back pain, sacroiliac joint pain, sacroiliitis, sacroiliac joint injection, sacroiliac joint dysfunction, provocation manuevers, controlled diagnostic blocks, intraarticular injection, extraarticular injection.

scholarly journals A Systematic Evaluation of the Therapeutic Effectiveness of Sacroiliac Joint Interventions

2012 ◽  
Vol 3;15 (3;5) ◽  
pp. E247-E278 ◽  
Author(s):  
Hans Hansen
Keyword(s):  
Systematic Review ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Randomized Trials ◽  
Low Back ◽  
Pulsed Radiofrequency ◽  
Short Term ◽  
Sacroiliac Joint Pain ◽  
Radiofrequency Neurotomy

Background: The contribution of the sacroiliac joint to low back and lower extremity pain has been a subject of debate with extensive research. It is generally accepted that approximately 10% to 25% of patients with persistent low back pain may have pain arising from the sacroiliac joints. In spite of this, there are currently no definite conservative, interventional, or surgical management options for managing sacroiliac joint pain. In addition, there continue to be significant variations in the application of various techniques as well as a paucity of literature. Study Design: A systematic review of therapeutic sacroiliac joint interventions. Objective: To evaluate the accuracy of therapeutic sacroiliac joint interventions. Methods: The available literature on therapeutic sacroiliac joint interventions in managing chronic low back and lower extremity pain was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria for randomized trials of interventional techniques and the criteria developed by the Newcastle-Ottawa Scale for observational studies. The level of evidence was classified as good, fair, or limited (or poor) based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature published from 1966 through December 2011 that was identified through searches of PubMed and EMBASE, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: For this systematic review, 56 studies were considered for inclusion. Of these, 45 studies were excluded and a total of 11 studies met inclusion criteria for methodological quality assessment with 6 randomized trials and 5 non-randomized studies. The evidence for cooled radiofrequency neurotomy in managing sacroiliac joint pain is fair. The evidence for effectiveness of intraarticular steroid injections is limited (or poor). The evidence for periarticular injections of local anesthetic and steroid or botulinum toxin is limited (or poor). The evidence for effectiveness of conventional radiofrequency neurotomy is limited (or poor). The evidence for pulsed radiofrequency is limited (or poor). Limitations: The limitations of this systematic review include a paucity of literature on therapeutic interventions, variations in technique, and variable diagnostic standards for sacroiliac joint pain. Conclusions: The evidence was fair in favor of cooled radiofrequency neurotomy and limited (or poor) for short-term and long-term relief from intraarticular steroid injections, periarticular injections with steroids or botulin toxin, pulsed radiofrequency, and conventional radiofrequency neurotomy. Key words: Chronic low back pain, sacroiliac joint pain, sacroiliitis, sacroiliac joint injection, sacroiliac joint dysfunction, thermal radiofrequency, pulsed radiofrequency

Sign in / Sign up

Export Citation Format

Share Document