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The Therapeutic Efficacy of Sacroiliac Joint Blocks With Triamcinolone Acetonide in the Treatment of Sacroiliac Joint Dysfunction Without Spondyloarthropathy

Liliang, Po-Chou, MD*; Lu, Kang, MD, PhD*; Weng, Hui-Ching, PhD; Liang, Cheng-Loong, MD*; Tsai, Yu-Duan, MD*; Chen, Han-Jung, MD, PhD*

doi: 10.1097/BRS.0b013e31819e2c78
Clinical Case Series

Study Design. Prospective case series.

Objective. The study aimed to investigate the therapeutic efficacy of sacroiliac joint (SIJ) blocks with triamcinolone acetonide in patients with SIJ pain without spondyloarthropathy.

Summary of Background Data. Numerous studies have demonstrated that SIJ blocks with corticosteroid/anesthetic provide long-term pain relief in seronegative spondyloarthropathy. However, only one report on SIJ dysfunction patients without spondyloarthropathy shows promising results.

Methods. We conducted a prospective observational study of patients at a University Spine Center from March 2005 to May 2006. The above mentioned SIJ blocks were performed in 150 patients, and dual SIJ blocks confirmed SIJ pain in 39 patients (26%).

Results. Twenty-six patients (66.7%) experienced significant pain reduction for more than 6 weeks; the overall mean duration of pain reduction in these responders was 36.8 ± 9.9 weeks. SIJ blocks were ineffective in 13 patients (33.3%); the mean duration of pain reduction in these patients was 4.4 ± 1.8 weeks. Univariate analysis revealed that treatment failure was significantly associated with a history of lumbar/lumbosacral fusion (P = 0.03).

Conclusion. SIJ blocks with triamcinolone acetonide are beneficial for some patients with SIJ pain without spondyloarthropathy. The SIJ blocks showed a long-lasting efficacy in two-thirds of the patients; however, the duration of its efficacy was shorter in patients with a history of lumbar/lumbosacral fusion. These findings suggest the need for further studies.

Sacroiliac joint blocks with triamcinolone acetonide are beneficial for treating some patients with sacroiliac joint dysfunction without spondyloarthropathy. The sacroiliac joint blocks showed long-lasting efficacy in two-thirds of the patients. The blocks have poor efficacy in patients with a history of lumbar/lumbosacral fusion.

From the *Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; and †Department of Health Management, I-Shou University, Kaohsiung, Taiwan.

Acknowledgment date: April 28, 2008. First revision date: June 26, 2008. Second revision date: August 20, 2008. Acceptance date: October 14, 2008.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Po-Chou Liliang, MD, Department of Neurosurgery, E-Da Hospital/I-Shou University, No 1, E-Da Rd, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, 824 Taiwan; E-mail: ed100172@edah.org.tw

© 2009 Lippincott Williams & Wilkins, Inc.