INTRODUCTION: Persistent pelvic pain following childbirth and sometimes not associated with childbirth represents a poorly understood situation in which disorders of the sacroiliac joints have been considered a possible source of pain. In cases of severe pain for long periods of time the question sometimes arises as to whether arthrodesis of these joints might be of value.
METHODS: Patients were selected on clinical grounds, with descriptions of pain localized to the sacroiliac area and non‐specific pain radiation down the leg/s. They had clinical signs of possible sacroiliac joint involvement but no abnormal radiological findings. All 55 patients were women, mean age 45 years (range 28 to 64). Mean duration of pelvic pain was 7 years (range 1‐30) and of non‐specific sciatica 6 years (range 0.5‐30). Preoperatively, the patients were given diagnostic injections against the sacroiliac joints of local anaesthetics or saline, to which they were blinded. The generic questionnaire SF‐36 and the disease specific Balanced Inventory for Spinal disorders (BIS) were answered by all patients before surgery and by 49 patients (89 %) at follow‐up 1‐3 years (mean 2 years) postoperatively.
RESULTS: At follow‐up 7 of the 55 patients reported being completely free from pelvic pain, 20 reported being much better, 9 somewhat better, 7 unchanged, 5 somewhat worse and 1 much worse. Similarly, of those with preoperative leg pain, 7 were completely free from that pain, 20 were much better, 7 somewhat better, 6 unchanged, 2 somewhat worse and 3 much worse. Regarding quality of life, 22 assessed it as much better, 9 somewhat better, 12 unchanged, 5 as somewhat worse and 1 as much worse.
DISCUSSION: The results indicate that within the selected subgroup of patients there might be patients whose pain emanates from the sacroiliac joints, where arthrodesis might be of value.