A systematic review of the clinical efficacy of sacroiliac joint stabilization in the treatment of lower back pain

2019 ◽  
Vol 82/115 (6) ◽  
pp. 655-663
Author(s):  
Jan Lodin ◽  
Jan Procházka ◽  
Marek Jelínek ◽  
Petr Waldauf ◽  
Martin Sameš ◽  
...  
Keyword(s):  
Systematic Review ◽  
Back Pain ◽  
Clinical Efficacy ◽  
Lower Back Pain ◽  
Sacroiliac Joint ◽  
Joint Stabilization ◽  
Lower Back

A Systematic Review of Clinical Pathways for Lower Back Pain and Introduction of the Saskatchewan Spine Pathway

Spine ◽  
2011 ◽  
Vol 36 ◽  
pp. S164-S171 ◽  
Author(s):  
Daryl R. Fourney ◽  
Joseph R. Dettori ◽  
Hamilton Hall ◽  
Roger Härtl ◽  
Matthew J. McGirt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Back Pain ◽  
Lower Back Pain ◽  
Clinical Pathways ◽  
Lower Back

scholarly journals The reliability of motion palpation versus a traditional chiropractic method for the analysis of chronic mechanical sacroiliac joint syndrome

2000 ◽  
Author(s):  
◽  
Paul Craig Birdsey
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Sacroiliac Joint ◽  
Reliable Method ◽  
Common Cause ◽  
Sacroiliac Joint Dysfunction ◽  
Lower Back

Sacroiliac joint syndrome represents a common cause of lower back pain (Cassidy and Burton 1992:3). However, much controversy exists regarding the most reliable method used to diagnose and determine sacroiliac joint dysfunction (Wiles and Faye 1992).

Sacroiliac Joint Pain

2021 ◽  
Author(s):  
Alaa Abd-Elsayed ◽  
Dawood Sayed
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Educational Resources ◽  
Diagnosis And Treatment ◽  
Evidence Based ◽  
Lower Back ◽  
Evidence Based Treatments ◽  
Emerging Treatments

Lower back pain attributed to the sacroiliac joint (SIJ) is prevalent but historically has been frequently underdiagnosed. Even when the SIJ is properly identified as a source of lower back pain, individuals suffering from SIJ dysfunction are often not treated effectively. Improved educational resources for clinicians based on effective evidence-based treatments for SIJ dysfunction are critical in improving the current gap in diagnosis and treatment. Several established and emerging treatments exist for patients with SIJ dysfunction, but prior to this text, no comprehensive resource has existed that addressed management of SIJ dysfunction. This text presents a full and up-to-date review of all the available treatments for SIJ dysfunction, with the aim of providing clinicians with a single comprehensive resource for treatment of their patients.

Editorial: Stabilization of the sacroiliac joint

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Editorial ◽  
Author(s):  
Christopher I. Shaffrey ◽  
Justin S. Smith
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Surgical Management ◽  
Lower Back Pain ◽  
Surgical Intervention ◽  
Facet Joint ◽  
Chronic Lower Back Pain ◽  
Low Back ◽  
Lower Back

Lower back pain and pain involving the area of the posterior iliac spine are extremely common. Degeneration of the sacroiliac joint (SIJ) is one potential cause for lower back pain and pain radiating into the groin or buttocks. Degenerative changes to the lumbar spine and sacroiliac joints are common. A recent study evaluating SIJ abnormalities in a primary low back pain population demonstrated 31.7% of patients demonstrated SI joint abnormalities.4 As is the case for the evaluation and management of isolated lower back pain, the evaluation, management, and role for surgical intervention in SIJ pain is very controversial.Many patients have degenerative changes of the disc, facet joints, and SIJs. A recent systematic review performed to determine the diagnostic accuracy of tests available to clinicians to identify the disc, facet joint, or SIJ as the source of low back pain concluded that tests do exist that change the probability of the disc or SIJ (but not the facet joint) as the source of low back pain.3 It was also concluded that the usefulness of these tests in clinical practice, particularly for guiding treatment selection, remains unclear.3Although there is general agreement that SIJ pathological changes are a potential cause of pain, there is far less agreement about the optimal management of these conditions. A variety of conditions can cause SIJ dysfunction including degenerative and inflammatory arthritis, trauma, prior lumbosacral fusion, hip arthritis, limb length inequality, infections, and neoplasia.8 There is increasing evidence that image intensifier-guided single periarticular injection can correctly localize pain to the SIJ but the optimal management strategy remains controversial. Recent publications have compared surgical versus injection treatments and fusion versus denervation procedures.1,8 A systematic review found improvement regardless of the treatment, with most studies reporting over 40% improvement in pain as measured by VAS or NRS scores.8 It cautioned that one of the studies reported 17.6% of patients experiencing mild/no pain compared with 82.4% experiencing marked/severe pain at 39 months after SIJ fusion procedures.6,8 This systematic review also noted that despite improvements in reported pain, less than half of patients who had work status reported as returning to work.8Because of the functional and socioeconomic consequences of chronic lower back pain, numerous surgical treatments to improve this condition have been attempted by spinal surgeons through the years. Arthrodesis of the SIJ is a surgical procedure with a long history dating to the beginnings of spinal surgery.7 Poor results, high complication rates and the need for additional surgical procedures have generally diminished the enthusiasm for this procedure until recently.6A variety of “minimally invasive” procedures have been recently introduced that have rekindled enthusiasm for the surgical management of SIJ pathology. The technique demonstrated in the “Stabilization of the SIJ with SI-Bone” is one of these new techniques. There has been a recent publication detailing the very short term clinical outcomes with this technique that reported encouraging results.5 In this series of 50 patients, quality of life questionnaires were available for 49 patients preoperatively, 41 patients at 3 months, 40 at 6 months and only 27 at 12 months, complicating the ability to accurately assess true outcomes.Although the focus of this video by Geisler is on the surgical technique, there should have been more information provided on the expected surgical outcomes and potential complications of SIJ fusion.2 The video only gives minimal information on how to appropriately select patients with potential SIJ pathology for surgical intervention. There are insufficient recommendations on the clinical and radiographic follow-up needed for this procedure. A concern with this implant is whether the porous plasma spray coating on the implant actually results in bone growth across the SIJ or only serves as a stabilizer. If true fusion does not result, deterioration in the clinical result could occur over time.This video nicely demonstrates the surgical technique of stabilization of the SIJ with SI-Bone product. There are numerous unanswered questions regarding patient selection for SIJ fusion or stabilization. There are an increasing number of surgical techniques for treating SIJ pathology and it is not clear which method may provide the best outcomes. Without prospective trials with nonconflicted surgeons and standardized selection criteria, the true role for SIJ fusion procedures in the management of chronic lower back pain will remain murky. The consequences of the unsupported enthusiasm for the surgical management of discogenic back pain still negatively impacts the public perception of spinal surgeons. Much more high quality information is needed regarding the surgical management of SIJ pathology before widespread use of this technique should be adopted.

Sacroiliac joint arthrodesis for chronic lower back pain

1987 ◽  
Vol 106 (4) ◽  
pp. 238-240 ◽  
Author(s):  
H. Waisbrod ◽  
J. -U. Krainick ◽  
H. U. Gerbershagen
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Sacroiliac Joint ◽  
Chronic Lower Back Pain ◽  
Lower Back

scholarly journals Mechanical lower back pain and sacroiliac joint dysfunction in golfers at two golf clubs in Durban, South Africa

2018 ◽  
Vol 74 (1) ◽  
Author(s):  
Siyabonga H. Kunene ◽  
Hlengiwe Luthuli ◽  
Mthandeni Nkosi ◽  
Maqsood Haffejee ◽  
Iftikaar Jooma ◽  
...  
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Sacroiliac Joint ◽  
Strong Association ◽  
Musculoskeletal Symptoms ◽  
Management Approach ◽  
Years Of Experience ◽  
Sacroiliac Joint Dysfunction ◽  
Lower Back ◽  
Golf Clubs

Background: Mechanical lower back pain (MLBP) and sacroiliac joint dysfunction (SIJD) are common problems among golfers. There are currently few studies on golfers regarding the relationship between MLBP and SIJD.Objective: The objective of this study was to determine the prevalence of MLBP and SIJD and their association in golfers at two golf clubs in Durban, South Africa.Method: A correlation design included convenience sampling. The Standardised Nordic Questionnaire for the analysis of musculoskeletal symptoms determined the prevalence of MLBP. Sacroiliac joint pain provocative tests determined the prevalence of SIJD. Institutional ethical clearance was granted and consent from participants was obtained. Data were collected over 3 weeks and SPSS was used to calculate descriptive and inferential statistics.Results: There were 271 participants dominated by males (86.7%) aged between 39 and 47 years (33.2%). A total of 123 (45%) of the participants presented with MLBP and 62 (23%) with SIJD. The MLBP prevalence was moderately associated with age (χ2 = 71.22, p = 0.004) and years of experience (χ2 = 69.93, p = 0.001). The SIJD prevalence was moderately associated with age (χ2 = 55.49, p = 0.003) and poorly associated with years of experience (χ2 = 44.93, p = 0.005). Twenty-two per cent (60) had both MLBP and SIJD and 54% (146) had neither. A strong association (χ2 = 88.234, p = 0.000) between MLBP and SIJD was observed.Conclusion: There was a high prevalence of MLBP and SIJD and a strong association between them. A comprehensive management approach is recommended for golfers with MLBP and SIJD.Clinical Implications: This study will provide valuable knowledge that will assist clinicians, especially physiotherapists, in their clinical management of golfers with MLBP and SIJD. Intervention studies are needed to address lower back and sacroiliac joint problems reported in this study.

scholarly journals Study protocol for a randomised controlled trial on the effect of local analgesia for pain relief after minimal invasive sacroiliac joint fusion: the ARTEMIS study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056204
Author(s):  
Sem M M Hermans ◽  
Jorm M Nellensteijn ◽  
Henk van Santbrink ◽  
Rob Knoef ◽  
Mattheus K Reinders ◽  
...  
Keyword(s):  
Back Pain ◽  
Postoperative Pain ◽  
Randomised Controlled Trial ◽  
Lower Back Pain ◽  
Sacroiliac Joint ◽  
Controlled Trial ◽  
Lower Back ◽  
Joint Fusion ◽  
Randomised Controlled ◽  
Sacroiliac Joint Fusion

IntroductionChronic lower back pain is a common report in the general population. A dysfunctional sacroiliac joint (SIJ) is estimated to be responsible for one in five patients with lower back pain. Minimally invasive sacroiliac joint fusion (MISJF) is a surgical procedure to treat SIJ dysfunction. During the procedure, the SIJ is stabilised by implants inserted percutaneously under fluoroscopy guidance. Postoperatively, patients often report a lot of pain, which contributes to patients taking high doses of painkillers (opioids for example,) and preventing early mobilisation. In several orthopaedic procedures, intraoperative infiltration of the wound bed results in decreased consumption of analgesics, earlier mobilisation and shorter hospitalisation time. The aim of this study is to investigate the effectiveness of intraoperative SIJ infiltration with analgesia in reducing postoperative pain after MISJF.Methods and analysisWe will perform a two-centre, prospective, double-blind, randomised controlled trial to determine whether SIJ infiltration with 1.5–5 cc bupivacaine 0.50% is superior to 1.5–5 cc placebo (NaCl 0.9%) in reducing postoperative pain in patients after MISJF, and to determine whether bupivacaine significantly reduces opioid use in the direct postoperative period. Patients will be randomised with 1:1 allocation for either bupivacaine (intervention) or placebo SIJ infiltration. Postoperative pain will be measured by the Visual Analogue Scale pain score at entry and exit recovery, 2, 4, 6, 24 and 48 hours postoperatively.Ethics and disseminationThis is the first trial that investigates the effectiveness of intraoperative SIJ infiltration with bupivacaine 0.50% in reducing postoperative pain after MISJF. If intraoperative SIJ infiltration with bupivacaine 0.50% proves to be effective, this might have important clinical implications, such as postoperative analgesics (opioids for example,) consumption, earlier mobilisation and potentially shorter hospitalisation time.Trial registration numberNL9151.

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