Abstract
The sacroiliac joint is a common source of chronic low back pain. Presently, a universally accepted diagnostic test does not exist. Additionally, limitations in history, physical examination, and radiographic testing make the diagnosis difficult. Sacroiliac joint injections are the best diagnostic tool. Unfortunately, the pain related to the sacroiliac joint is not always adequately treated by intraarticular injections. Radiofrequency lesioning of the posterior nerve supply to the joint has emerged as an option for chronic refractory cases. We aim to review diagnosis and provide interventional technique guidance to treat this disorder.
References
Simopoulos TT, Manchikanti L, Gupta S, Aydin SM, Kim CH, Solanki D, Nampiaparampil DE, Singh V, Staats PS, Hirsch JA. Systematic review of the diagnostic accuracy and therapeutic effectiveness of sacroiliac joint interventions. Pain Physician 2015; 18:E713–E756.
Peterson C, Hodler J. Evidence-based radiology (part 1): is there sufficient research to support the use of therapeutic injections for the spine and sacroiliac joints? Skelet Radiol. 2010;39:5–9.
Muhlner SB. Review article: radiofrequency neurotomy for the treatment of sacroiliac joint syndrome. Curr Rev Musculoskelet Med. 2009;2:10–4.
Ackerman SJ, Polly DW, Knight T. Nonoperative care to manage sacroiliac joint disruption and degenerative sacroiliitis: high costs and medical resource utilization in the United States Medicare population. J Neurosurg Spine. 2014;20:354–63.
Goldthwait JE, Osgood RB. A consideration of the pelvic articulations from an anatomical, pathological, and clinical standpoint. Boston Med Surg J. 1905;152:634–8.
Smith-Peterson MN, Rogers WA. End-result study of arthrodesis of the sacroiliac joint for arthritis-traumatic and non-traumatic. J Bone Joint Surg Am. 1926;8:118–36.
Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med. 1934;211:210–5.
Ghormley RK. Backache: examination and differential diagnosis. JAMA. 1944;125:412–6.
Haldeman KO, Soto-Hall R. The diagnosis and treatment of sacroiliac conditions by the injection of procaine (novocain). J Bone Joint Surg Am. 1938;20:675–85.
Miskew DB, Block RA, Witt PF. Aspiration of infected sacro-iliac joints. J Bone Joint Surg. 1979;61A:1071–2.
Hendrix RW, Lin PJ, Kane WJ. Simplified aspiration or injection technique for the sacro-iliac joint. J Bone Joint Surg. 1982;64A:1249–52.
Ferrante FM, King LF, Roche EA, et al. Radiofrequency sacroiliac joint denervation for sacroiliac syndrome. Reg Anesth Pain Med. 2001;26:137–42.
Vallejo R, Benyamin RM, Kramer J, et al. Pulsed radiofrequency denervation for the treatment of sacroiliac joint syndrome. Pain Med. 2006;7:429–34.
Kapural L, Nageeb F, Kapural M, et al. Cooled radiofrequency system for the treatment of chronic pain from sacroiliitis: the first case-series. Pain Pract. 2008;8:348–54.
Yin W, Willard F, Carreiro J, et al. Sensory stimulation-guided sacroiliac joint radiofrequency neurotomy: technique based on neuroanatomy of the dorsal sacral plexus. Spine (Phila Pa 1976). 2003;28:2419–25.
Fortin JD. Sacroiliac joint dysfunction: a new perspective. J Back Musculoskel Rehabil. 1993;3:31–43.
Smidt GL, Wei SH, McQuade K, et al. Sacroiliac motion for extreme hip positions: a fresh cadaver study. Spine (Phila Pa 1976). 1997;22:2073–82.
Bowen V, Cassidy JD. Macroscopic and microscopic anatomy of the sacroiliac joint from embryonic life until the eighth decade. Spine (Phila Pa 1976). 1981;6:620–8.
Brooke R. The sacroiliac joint. J Anat. 1924;58:299–305.
Gunterberg B, Romanus B, Stener B. Pelvic strength after major amputation of the sacrum: an experimental study. Acta Orthop Scand. 1976;47:635–42.
Miller JA, Schultz AM, Andersson GB. Load-displacement behavior of sacroiliac joints. J Orthop Res. 1987;5:92–101.
Albee FHA. Study of the anatomy and the clinical importance of the sacroiliac joint. JAMA. 1909;16:1273–6.
MacDonald GR, Hunt TE. Sacroiliac joints. Observations on the gross and histological changes in the various age groups. Can Med Assoc J. 1952;66:157–63.
Hammer N, Steinke H, Lingslebe U, et al. Ligamentous influence in pelvic load distribution. Spine J. 2013;13:1321–30.
Vanelderen P, Szadek K, Cohen SP, et al. Sacroiliac joint pain. Pain Pract. 2010;10:470–8.
Forst SL, Wheeler MT, Fortin JD, et al. The sacroiliac joint: anatomy, physiology, and clinical significance. Pain Physician. 2006;9:61–7.
Slipman CW, Whyte WS, Chow DW, et al. Sacroiliac joint syndrome. Pain Physician. 2001;4:143–52.
Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy diagnosis, and treatment. Anesth Analg. 2005;101:1440–53.
Hansen H, Helm S. Sacroiliac joint pain and dysfunction. Pain Physician. 2003;6:179–89.
Van der Wurff P, Buijs EJ, Groen GJ. Intensity mapping of pain referrals areas in sacroiliac joint pain patients. J Manip Physiol Ther. 2006;29:190–5.
Hansen H, Manchikanti L, Simopoulos TT, et al. A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician. 2012;15:E247–78.
Hansen HC, McKenzie-Brown AM, Cohen SP, et al. Sacroiliac joint interventions: a systematic review. Pain Physician. 2007;10:165–84.
Irwin RW, Watson T, Minick RP, et al. Age, body mass index, and gender differences in sacroiliac joint pathology. Am J Phys Med Rehabil. 2007;86:37–44.
Simpson R, Gemmell H. Accuracy of spinal orthopedic tests: a systematic review. Chiropr Osteopat. 2006;14:26.
Young S, April C, Laslett M. Correlation of clinical examination characteristics with three sources of chronic low back pain. Spine J. 2003;3:460–5.
Borowsky CD, Fagen G. Sources of sacroiliac region pain: insights gained from a study comparing standard intra-articular injection with a technique combining intra- and peri-articular injection. Arch Phys Med Rehabil. 2008;89:2048–56.
Merskey H, Bogduk N. Classification of chronic pain. In: Merskey H, Bogduk N, editors. Descriptions of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle: IASP Press; 1994. p. 180–1.
Vleeming A, Schuenke MD, Masi AT, et al. The sacroiliac joint: an overview of its anatomy, function, and potential clinical implications. J Anat. 2012;221:537–67.
Ikeda R. Innervation of the sacroiliac joint. Macroscopic and histological studies. Nihon Ika Daigaku Zasshi. 1991;58:587–96.
Szadek KM, Hoogland PV, Zuurmond WW, et al. Possible nociceptive structures in the sacroiliac joint cartilage: an immunohistochemical study. Clin Anat. 2010;23:192–8.
Szadek KM, Hoogland PV, Zuurmond WW, et al. Nociceptive nerve fivers in the sacroiliac joint in humans. Reg Anesth Pain Med. 2008;33:36–43.
Fortin JD, Kissling RO, O’Connor BL, et al. Sacroiliac joint innervation and pain. Am J Orthop. 1999;28:687–90.
McGrath MC, Zhang M. Lateral branches of dorsal sacral nerve plexus and the long posterior sacroiliac ligament. Surg Radiol Anat. 2005;27:327–30.
Solonen KA. The sacroiliac joint in the light of anatomical, roentgenological and clinical studies. Acta Orthop Scand Suppl. 1957;27:1–127.
Rosenberg J, Quint TJ, de Rosayro AM. Computerized tomographic localization of clinically-guided sacroiliac joint injections. Clin J Pain. 2000;16:18–21.
Dussault RG, Kaplan PA, Anderson MW. Fluoroscopy-guided sacroiliac joint injections. Radiology. 2000;214:273–7.
Fortin JD, Tolchin RB. Sacroiliac provocation and arthrography. Arch Phys Med Rehabil. 1993;74:125–9.
Gupta S. Double needle technique: an alternative method for performing difficult sacroiliac joint injections. Pain Physician. 2011;14:281–4.
Vanelderen P, Zundert JV. Radiofrequency treatment of the sacroiliac joint: quo Vadis? Pain Prac. 2011;11:1–2.
Holm S, Indahl A, Solomonow M. Sensorimotor control of the spine. J Electromyogr Kinesiol. 2002;12:219–34.
Cosman ER, Gonzalez CD. Bipolar radiofrequency lesion geometry: implications for palisade treatment for sacroiliac joint pain. Pain Pract. 2010;11:3–22.
Burnham RS, Yasui Y. An alternate method of radiofrequency neurotomy of the sacroiliac joint: a pilot study of the effect on pain, function, and satisfaction. Reg Anesth Pain Med. 2007;32:12–9.
Cohen SP, Zundert JV. Pulsed radiofrequency: rebel without cause. Reg Anesth Pain Med. 2010;35:8–10.
Cohen SP, Hurley RW, Buckenmaier CC, et al. Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology. 2008;109:279–88.
Cohen SP, Abdi S. Lateral branch blocks as a treatment for sacroiliac joint pain: a pilot study. Reg Anesth Pain Med. 2003;28:113–9.
Ho KY, Hadi MA, Pasutharnchat K, et al. Cooled radiofrequency denervation for treatment of sacroiliac joint pain: two year results from 20 cases. J Pain Res. 2013;6:505–11.
Manchikanti L, FJE F, Benyamin RM, et al. Assessment of bleeding risk of interventional techniques: a best evidence synthesis of practice patterns and perioperative management of anticoagulant and antithrombotic therapy. Pain Physician. 2013;16:SE261–318.
Cheng J, Pope JE, Dalton JE, et al. Comparative outcomes of cooled versus traditional radiofrequency ablation of the lateral branches for sacroiliac joint pain. Clin J Pain. 2013;29:132–7.
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Jani, S., Simopoulos, T.T. (2018). Sacroiliac Joint Interventions. In: Manchikanti, L., Kaye, A., Falco, F., Hirsch, J. (eds) Essentials of Interventional Techniques in Managing Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-60361-2_18
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DOI: https://doi.org/10.1007/978-3-319-60361-2_18
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