Sacroiliac joint injection for management sacroiliac joint pain after lumbosacral spinal fusion surgery: A prospective study at the single center in Vietnam

Abstract

Study designProspective observational study. ObjectiveSacroiliac joint (SIJ) pain after lumbar spinal fusion surgery is a common problem. This study aims to evaluate the response to intra-articular SIJ injection. Summary of background dataFollowing the fusion surgery, some patients may have recurrent and new low back pain that is different from that seen before the lumbosacral spinal surgery. SIJ-related pain is a possible cause of persistent postoperative pain. SIJ injection could be an effective option for these patients. MethodsThis prospective study includes 56 patients who had lumbosacral fusion from February 2018 to June 2022 and developed postoperative SIJ pain that was not responding to conservative treatment. These patients underwent intra-articular SIJ injection and were followed up for three months after injection. Patients were assessed with the Visual Analog Scale (VAS), and the Oswestry Disability Index (ODI). ResultsOf the 56 patients, 12 (21.4%) were male and 44 (78.6%) were female. Lumbar spinal stenosis was a common cause of prior surgery (78.6%). Up to 57.1% of patients had 2-level fusion surgery and 71.4% received fusion to S1. The mean age was 58.5 ± 10.7 years. Low-back pain and low-back pain radiating to the legs accounted for 64.3% and 37.5% respectively. Thirty-three patients (58.9%) had positive provocative tests and 27 (48.2%) had severe pre-injection pain with VAS and ODI scores. There was a significant improvement in post-injection VAS and ODI scores (p < 0.05). Patients with shorter fusion surgery had a better response to SIJ injection. ConclusionsSIJ pain is common following spinal fusion surgery. Significant improvement in disability and pain could be achieved within 3 months after intra-articular injection. We had realized a correlation between the level of fusion and the resultant treatment effect. SIJ injection could be an effective, safe option to improve the outcomes in patients who failed conservative management.