Algorithm for the Diagnosis and Treatment of the Dysfunctional Sacroiliac Joint

Dall, Bruce E.; Eden, Sonia V.; Rahl, Michael D.; Smith, Arnold Graham

doi:10.1007/978-3-319-10726-4_6

Cited by 5 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The posterior midline surgery used was first published over two decades ago and utilized fascial splitting and pedicle screw fixation [10]. It subsequently underwent modifications to spare muscle tissue which was published in 2015 [11]. This surgery provides excellent fixation allowing full weight bearing immediately postsurgery.…”

Section: Discussionmentioning

confidence: 99%

“…Our main referral source for these patients was from orthopedic and neurosurgeons. As a result of using our published Algorithm to diagnose and treat sacroiliac joint pain [9], the pain generators in the lumbosacral spine were also identified. This resulted in 17 patients having a simultaneous lumbosacral fusion repair or extension at the time of their SIJ fusion(s) based on extensive pre-operative diagnostics and planning.…”

Section: Discussionmentioning

confidence: 99%

“…All patients were diagnosed using the published "Algorithm for the Diagnosis and Treatment for Sacroiliac Joint Pain" [9], and each patient had one or more positive diagnostic injections establishing the SIJ(s) as a pain generator as well as further diagnostic injections for suspected lumbosacral pain generators. The surgery performed was the published posterior midline fascial splitting and open approach, which was further modified to be muscle sparing [10,11]. In surgery the entire Posterior Superior Iliac Spine (PSIS) was used as bone graft being placed into the dorsal SIJ.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Long-Term Outcomes in Obese, Severely Obese, and Morbidly Obese Patients having Open Posterior Midline Sacroiliac Joint Fusions for Disabling and Dysfunctional Sacroiliac Joint Pain

Dall¹

2023

J Clin Med Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Outcomes in Obese, Severely Obese, and Morbidly Obese Patients having Open Posterior Midline Sacroiliac Joint Fusions for Disabling and Dysfunctional Sacroiliac Joint Pain

Dall¹

2023

J Clin Med Surgery

View full text Add to dashboard Cite

show abstract

“…Few studies have examined the timing of initiation of postoperative rehabilitation following fusion surgeries. Dall et al 42 recommend initiation of physical therapy within two weeks following posterior minimally invasive SIJ fusion. Initial restrictions include no bending or lifting more than 10 lbs, no twisting at the waist for 12 weeks.…”

Section: Methodsmentioning

confidence: 99%

Best Practices for Postoperative Management of Posterior Sacroiliac Joint Fusion

Buchanan¹,

Lee²,

Comer³

et al. 2022

JPR

View full text Add to dashboard Cite

Sacroiliac joint (SIJ) pain is a common cause of low back pain. Traditionally, treatment for SIJ joint pain and dysfunction has consisted of physical therapy, medication management, SIJ injections, and SIJ ablations. Improved recognition of the SIJ as an etiology for back pain has led to advances in treatment options. Radiofrequency of the lateral sacral branches has been shown to be effective, though evidence is fraught with inconsistent patient selection, study design and procedural technique. It also does not directly address the mechanical dysfunction of the SIJ. In order to create a more enduring approach SIJ fusion has become an attractive option to reduce pain and to improve function. This method of SI joint treatment requires guidance in the perioperative phase of care from both the physicians and advanced practice providers (APP). In order to improve care and outcomes of those undergoing posterior SI joint fusion the American Society of Pain and Neuroscience appointed an expert panel of physicians and advanced practice providers to create a best practice for the post operative care of this approach. As with any best practice, the panel considered current peer reviewed literature and clinical expertise to create guidance today. This is intended to be a living document with modifications as additional evidence comes to light in data publication. The goals of this paper are to focus on (1) wound care, (2) medication use, (3) physical activity and (4) therapeutic exercises.

show abstract

“…If a patient has a positive response to 3 or more SIJ provocative tests, the pain is likely due to pathology in the SIJ and may result in a positive diagnostic SIJ block. 7 , 8 The SIJ block consists of intraarticular injection of corticosteroids and local anesthetics to reduce inflammation and pain, which can be both diagnostic and therapeutic. Current standards suggest that a 75% pain improvement after two separate injections is considered a positive diagnosis of sacroiliitis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Lateral View Needle Placement for Sacroiliac Joint Injections

Johansen,

Nguyen,

Mohamed

et al. 2024

JPR

View full text Add to dashboard Cite

Introduction Sacroiliac joint (SIJ) pathology is typically diagnosed and treated with fluoroscopy-guided intraarticular injections. Most practitioners use only an anteroposterior (AP) or oblique view. Although injection into the periarticular space may yield adequate pain relief, intraarticular needle placement is imperative to identify SIJ pathology and plan future management. This study highlights the importance of obtaining an additional lateral view during fluoroscopy to better evaluate SIJ disease. Methods A retrospective review of 38 patients who underwent fluoroscopy guided SIJ injection was conducted, for which IRB approval was granted by the MetroWest Medical Center Institutional Review Board. Patient demographics (age, sex, BMI) and pre- and post-operative numerical rating scale (NRS) scores were collected, and initial needle location was reviewed. Patients were placed into groups according to initial needle location. Statistical analysis was conducted using a Mann–Whitney U -test with significance defined as p < 0.05. Results The 21 females and 17 males had a mean age and BMI of 70.5 years and 27.8 kg/m 2 , respectively. Thirty-one patients had initial intraarticular needle placement confirmed with lateral arthrogram, and 7 patients had initial periarticular needle placement, requiring needle readjustment in lateral confirmatory view. Both groups had similar demographic characteristics. No statistically significant differences were found between the two groups’ mean NRS score improvement ( p =0.108). Conclusion Using only the AP or oblique view during needle placement results in miss rates of nearly 20% while adding a lateral view can lower miss rates to near 0%. While pain relief may be adequate in either case, proper diagnosis and future management relies upon accurate needle placement.

show abstract

Algorithm for the Diagnosis and Treatment of the Dysfunctional Sacroiliac Joint

Cited by 5 publications

References 25 publications

Long-Term Outcomes in Obese, Severely Obese, and Morbidly Obese Patients having Open Posterior Midline Sacroiliac Joint Fusions for Disabling and Dysfunctional Sacroiliac Joint Pain

Long-Term Outcomes in Obese, Severely Obese, and Morbidly Obese Patients having Open Posterior Midline Sacroiliac Joint Fusions for Disabling and Dysfunctional Sacroiliac Joint Pain

Best Practices for Postoperative Management of Posterior Sacroiliac Joint Fusion

Efficacy of Lateral View Needle Placement for Sacroiliac Joint Injections

Contact Info

Product

Resources

About