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Fluoroscopically Guided Therapeutic Sacroiliac Joint Injections for Sacroiliac Joint Syndrome

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

American Journal of Physical Medicine & Rehabilitation: June 2001 - Volume 80 - Issue 6 - p 425-432
Research Articles: Low-Back Pain
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Slipman CW, Lipetz JS, Plastaras CT, Jackson HB, Vresilovic EJ, Lenrow DA, Debra L. Braverman DL: Fluoroscopically guided therapeutic sacroiliac joint injections for sacroiliac joint syndrome. Am J Phys Med Rehabil 2001;80:425–432.

Objective To investigate the outcomes resulting from the use of fluoroscopically guided therapeutic sacroiliac joint injections in patients with sacroiliac joint syndrome.

Design A retrospective study design with independent clinical review was utilized. Thirty-one patients were included; each patient met specific physical examination criteria and failed to improve clinically after at least 4 wk of physical therapy. Each patient demonstrated a positive response to a fluoroscopically guided diagnostic sacroiliac joint injection. Therapeutic sacroiliac joint injections were administered in conjunction with physical therapy. Outcome measures included Oswestry scores, Visual Analog Scale pain scores, work status, and medication usage.

Results Patients’ symptom duration before diagnostic injection averaged 20.6 mo. An average of 2.1 therapeutic injections was administered. Follow-up data collection was obtained at an average of 94.4 wk. A significant reduction (P = 0.0014) in Oswestry disability score was observed at the time of follow-up. Visual Analog Scale pain scores were reduced (P < 0.0001) at the time of discharge and at follow-up. Work status was also significantly improved at the time of discharge (P = 0.0313) and at follow-up (P = 0.0010). A trend (P = 0.0645) toward less drug usage was observed.

Conclusions These initial findings suggest that fluoroscopically guided therapeutic sacroiliac joint injections are a clinically effective intervention in the treatment of patients with sacroiliac joint syndrome. Controlled, prospective studies are necessary to further clarify the role of therapeutic injections in this patient population.

From The Penn Spine Center, Department of Rehabilitation Medicine (CWS, JSL, CTP, HBJ, EJV, DAL, DLB) and Orthopaedic Surgery (EJV), Philadelphia, Pennsylvania.

All correspondences and requests for reprints should be addressed to Curtis W. Slipman, MD, Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Ground Floor White Bldg., Philadelphia, PA 19104.

© 2001 Lippincott Williams & Wilkins, Inc.