Sacroiliac dysfunction in radiologically diagnosed disk herniation

Abstract

Issue of our study was to evaluate to which extend SI-joint dysfunctions in patients with lumbar and ischiadic pain and CAT-scan positive disk herniations were present and source of their symptoms. The group studied consisted of 150 patients with low back pain and sciatica and lack of sensory or motor losses; all patients had CAT-scan positive disk herniations. In 46 patients (group A) we found sacroiliac joint dysfunctions which we treated with manual medicine techniques. The remaining 104 patients (group B) had no SI-dysfunctions. Regardless of differing clinical findings all patients received intensive physiotherapy throughout their hospitalization. 34 patients of group A (73.9 %) reported an improvement, 5 patients were painfree. 57 patients of group B (54.8 %) reported an improvement. However, nobody in group B was painfree. 5 patients of group A (10.8 %) and 19 patients of group B (18.3 %) whose symptoms were resistent to nonoperative treatment finally underwent nucleotomy. We conclude that patients suffering from lumbar and ischiadic pain should undergo manual diagnosis despite the imaging proven disk herniation. Thus wrong indications for nucleotomy might be avoided.