Far-Contralateral Oblique (FCO) Sacroiliac Joint Injection: Description of a Novel Technique

Lee, David W.; Buchanan, Patrick J.; Vodapally, Shashank; James, Christopher; Diep, Jack

doi:10.1155/2022/3312589

Cited by 2 publications

(1 citation statement)

References 24 publications

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“… 14 Another study by Lee et al proposes the use of an alternative far-contralateral oblique approach for sacroiliac joint injection with lateral fluoroscopic imaging to confirm injection location. 15 Their study concluded that their proposed technique can be utilized to determine candidacy for SIJ fusion. Our study builds on these two studies by demonstrating the efficacy of an additional lateral view during SIJ injection.…”

Section: Discussionmentioning

confidence: 96%

Efficacy of Lateral View Needle Placement for Sacroiliac Joint Injections

Johansen,

Nguyen,

Mohamed

et al. 2024

JPR

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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.

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Section: Discussionmentioning

confidence: 96%

Efficacy of Lateral View Needle Placement for Sacroiliac Joint Injections

Johansen,

Nguyen,

Mohamed

et al. 2024

JPR

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Intrathecal hydromorphone for analgesia after partial hepatectomy: a randomized controlled trial

Ding

Chen

et al. 2022

Reg Anesth Pain Med

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IntroductionThere is substantial interest in adding intrathecal opioids, such as hydromorphone to the multimodal pain management strategies. We conducted a randomized controlled trial to examine whether adding intrathecal hydromorphone to a multimodal strategy could safely improve analgesic efficacy for patients undergoing partial hepatectomy.MethodsA total of 126 adult patients undergoing partial hepatectomy under general anesthesia were randomly assigned to receive intrathecal hydromorphone (100 μg) or no block. The primary outcome was the incidence of moderate to severe pain during movement at 24 hours after surgery. Secondary outcomes included the incidence of moderate to severe pain during rest or movement at different times within 72 hours, pain scores during rest or movement within 72 hours after surgery, analgesic use, adverse events, and indicators of postoperative recovery.ResultsAmong the 124 patients analyzed, the intrathecal hydromorphone group showed a lower incidence of moderate to severe pain during movement at 24 hours after surgery (29.0% vs 50%; RR 0.58, 95% CI 0.37 to 0.92) than the control group. However, the absolute difference in pain scores on a numerical rating scale was less than 1 between the two groups at 24 hours after surgery. Mild pruritus within the first 24 hours after surgery was more frequent in the intrathecal hydromorphone group (19.4% vs 4.8%; p=0.01).DiscussionIntrathecal hydromorphone 100 μg reduced the incidence of moderate to severe pain and pain scores during movement within 24 hours after partial hepatectomy. However, the difference in pain scores may not be clinically significant, and intrathecal hydromorphone 100 μg did not significantly improve other analgesic or functional outcomes. Further investigation is needed to optimize the intrathecal hydromorphone dose.Trial registration numberChiCTR2000030652.

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Far-Contralateral Oblique (FCO) Sacroiliac Joint Injection: Description of a Novel Technique

Cited by 2 publications

References 24 publications

Efficacy of Lateral View Needle Placement for Sacroiliac Joint Injections

Efficacy of Lateral View Needle Placement for Sacroiliac Joint Injections

Intrathecal hydromorphone for analgesia after partial hepatectomy: a randomized controlled trial

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