Fluoroscopically Guided Therapeutic Sacroiliac Joint Injections for Sacroiliac Joint Syndrome

Slipman, Curtis W.; Lipetz, Jason S.; Plastaras, Christopher T.; Jackson, Howard B.; Vresilovic, Edward J.; Lenrow, David A.; Braverman, Debra L.

doi:10.1097/00002060-200106000-00007

Cited by 111 publications

(83 citation statements)

References 29 publications

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“…[20] As a result, in recent years, intraarticular steroid injections have become more popular. [1,3,11,21] Hence, in our study, we tried to investigate the effectiveness of a single-needle technique steroid injection under the guidance of CT with a minimum of two years of follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the complex anatomy, SIJ injections have a very low success rate of 12-20% when performed using only clinical judgement. [21,38,39] In addition, radiological imaging as a guidance method has been recently applied to place the needle into the SIJ space. An increasing success rate with regard to the correct positioning of the needle starting from 60% at the first 30 injections and improving to 93.5% with the last 30 injections has been demonstrated, but the therapeutic efficacy or clinical outcome of this intervention has not been evaluated.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…It has also been commonly reported that the pain reduction and functional improvement after therapeutic injections of the SIJ often is quite significant. [21,26] The reason for this improvement is believed to be mostly dependent on the long-term anti-inf lammatory effects of steroids, including the prevention of synthesis of pain-generating molecules. For this reason, we used one of the most long-term effective steroid molecules, triamcinolone acetonide and believe that this allowed for up to two years of pain relief to be established in our study group.…”

Section: Sacroiliac Joint Pain and The Effect Of Corticosteroidsmentioning

confidence: 99%

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An Intraarticular Sacroiliac Steroid Injection Under the Guidance of Computed Tomography for Relieving Sacroiliac Joint Pain: A Clinical Outcome Study with Two Years of Follow-Up

et al. 2012

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Amaç: Bu çalışmada, iki yıllık takip dönemi süresince bilgisayarlı tomografi (BT) eşliğinde gerçekleştirilen eklem içi steroid ve lokal anestetik enjeksiyonun, sakroiliyak eklem (SİE) ağrısının tedavisindeki etkinliği değerlendirildi. Hastalar ve yöntemler:Ocak 2009 -Aralık 2011 tarihleri arasında SİE ağrısı olan ve BT eşliğinde eklem içi steroid ve lokal anestetik enjeksiyonu yapılması planlanan toplam 46 hasta (18 erkek, 28 kadın; ort. yaş 52.7 yıl; dağılım 41-65 yıl) çalışmaya dahil edildi. Uygun hazırlık sonrası, 80 mg triamsinolon asetonid ve 4 cc bupivakain hidroklorür karışımı BT eşliğinde enjekte edildi. Enjeksiyon öncesi ve sonrası ağrının derecesi görsel analog skalası (GAS) kullanılarak değerlendirildi. Klinik takip enjeksiyon sonrası ilk gün, ilk hafta, üçüncü hafta, altıncı ay ve son kontrol olarak gerçekleştirildi. Enjeksiyon öncesi ve sonrası GAS skorları arasındaki fark istatistiksel olarak değerlendirildi. Bulgular:Ortalama takip süresi 26.7 ay (dağılım 24-36 ay) idi. Kırk altı hastadan sekizine (%17.4) ikinci enjeksiyon gereksinimi oldu. Bunların beşinde (%10.8) eklem içi kortizon enjeksiyonu sonrası takipte, ağrılarda gerileme olmadığı görüldü. Sakroiliyak eklem enjeksiyonun genel başarı yüzdesi %89.2 idi. Enjeksiyon sonrası ilk gün, ilk hafta, üçüncü hafta ve altıncı ayda kaydedilen tüm GAS skorları, enjeksiyon öncesine kıyasla anlamlı düzeyde düşük bulundu. Bu yanıt, en az iki yıllık takip sonucunda da ortanca 20.5 GAS (min-max: 0-87) ile anlamlı şekilde kalmaya devam etti.Sonuç: Bilgisayarlı tomografi eşliğinde SİE enjeksiyonları, aktif SİE patolojileri nedeni ile ağrı duyan hastalarda yeterli bir tedavi yöntemidir. Bu yöntem güvenilir ve etkilidir ve uzun dönemli SİE ağrısı olan hastalarda tedavi alternatifi olarak tercih edilebilir.Anahtar sözcükler: Bilgisayarlı tomografi; enjeksiyon; ağrı; sakroiliyak. Objectives:The aim of this study was to analyze the effectiveness of an injection of a computed tomography (CT)-guided intraarticular steroid and a local anesthetic for the treatment of sacroiliac joint (SIJ) pain over a two-year follow-up period. Patients and methods:Between January 2009 and December 2011, a total of 46 patients (18 males, 28 females; mean age 52.7 years; range 41 to 65 years) with SIJ pain who were scheduled to undergo an injection with a CT-guided intraarticular steroid and a local anesthetic were included. After properly prepared, the mixture of triamcinolone acetonide 80 mg and bupivacaine hydrochloride 4 cc was injected under CT guidance. The pain was evaluated using the visual analog scale (VAS) before and after the injection. The clinical follow-up was performed the day after the injection as well as at one week, three weeks, and six months and in the last visit. The differences between the VAS scores before and after the injections were analyzed statistically. Results:The mean follow-up was 26.7 months (range 24 to 36 months). Eight out of 46 patients (17.4%) needed a second injection. Five of them (10.8%) failed to show improvement during the follow-up after the...

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Outcomesmentioning

confidence: 99%

Section: Sacroiliac Joint Pain and The Effect Of Corticosteroidsmentioning

confidence: 99%

See 1 more Smart Citation

An Intraarticular Sacroiliac Steroid Injection Under the Guidance of Computed Tomography for Relieving Sacroiliac Joint Pain: A Clinical Outcome Study with Two Years of Follow-Up

et al. 2012

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13] In a recent study by Sembrano and Polly, 200 consecutive new patients were examined in a spine clinic with a chief complaint of low back pain and no prior history of spine, sacroiliac joint, or hip surgery. 12 Sixty-five percent of these patients were found to have pain attributed to the spine only, while 5% had pain attributed to the sacroiliac joint only, and 14.5% had pain attributed to both.…”

Section: Introductionmentioning

confidence: 99%

Comparative Effectiveness of Open versus Minimally Invasive Sacroiliac Joint Fusion

et al. 2014

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Background:The mainstay of sacroiliac joint disruption/degenerative sacroiliitis therapy has been nonoperative management. This nonoperative management often includes a regimen of physical therapy, chiropractic treatment, therapeutic injections, and possibly radiofrequency ablation at the discretion of the treating physician. When these clinical treatments fail, sacroiliac joint fusion has been recommended as the standard treatment. Open and minimally invasive (MIS) surgical techniques are typical procedures. This study aims to compare the perioperative measures and Oswestry Disability Index (ODI) outcomes associated with each of these techniques. Methods: A comparative retrospective chart review of patients with sacroiliac joint fusion and a minimum of 1 year of follow-up was performed. Perioperative measures and ODI scores were compared using the Fisher's exact test and two nonparametric tests, ie, the (median 53 [14-84]). Postoperative improvement in ODI was statistically significant within and between groups, with MIS resulting in greater improvement. Conclusion:The open and MIS sacroiliac joint fusion techniques resulted in statistically and clinically significant improvement for patients with degenerative sacroiliitis refractory to nonoperative management. However, the number of patients reaching the minimal clinically important difference and those showing overall improvement were greater in the MIS group.

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“…Intraarticular corticosteroid injections have been reported to be significantly beneficial for pain in this joint. [5] There is no consensus on the type of steroids that should be used, but long-acting corticosteroids are preferred. Steroids that include betamethasone sodium phosphate or acetate and methylprednisolone are usually injected into the SI joint to reduce inflammation and pain.…”

mentioning

confidence: 99%

Sacroiliac Joint Injections in Patients with Sacroiliitis: Which is the Right Way?

Tur

2012

Turk J Rheumatol

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Fluoroscopically Guided Therapeutic Sacroiliac Joint Injections for Sacroiliac Joint Syndrome

Cited by 111 publications

References 29 publications

An Intraarticular Sacroiliac Steroid Injection Under the Guidance of Computed Tomography for Relieving Sacroiliac Joint Pain: A Clinical Outcome Study with Two Years of Follow-Up

An Intraarticular Sacroiliac Steroid Injection Under the Guidance of Computed Tomography for Relieving Sacroiliac Joint Pain: A Clinical Outcome Study with Two Years of Follow-Up

Comparative Effectiveness of Open versus Minimally Invasive Sacroiliac Joint Fusion

Sacroiliac Joint Injections in Patients with Sacroiliitis: Which is the Right Way?

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