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Puncture technologies in the treatment of pain syndrome caused by sacroiliac joint dysfunction

https://doi.org/10.14412/2074-2711-2020-4-32-36

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Abstract

Sacroiliac joint (SIJ) dysfunction is a cause of low back pain in 10–30% of cases. In 1993, the International Association for the Study of Pain (IASP) defined the following set of diagnostic criteria necessary to diagnose SIJ dysfunction: 1) the presence of pain in the areas characteristic of SIJ lesions, with special attention to pain in the Fortin area projection, with possible different types of radiation; 2) positive pain provocation tests for a SIJ lesion; 3) reduced pain after intra-articular anesthetic injection; 4) the lack of a specific nature of the lesion (fracture, inflammation, tumor, etc.). Injection of 0.5–2.5 ml of solution of an anesthetic (bupivacaine, lidocaine) and 20–40 mg of triamcinolone or 5 mg of betamethasone (1 ml) into the SIJ area is used as interventional technologies. More prolonged analgesia involves radiofrequency denervation (RFD) of the SIJ, in which needles with electrodes are placed in the projection of the nerves that innervate the SIJ, and their local thermal destruction is performed. The effectiveness of RFD of SIJ requires further investigation.

About the Authors

K. A. Belozerskikh
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Konstantin Aleksandrovich Belozerskikh

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, University Clinical Hospital Three

11, Rossolimo St., Build. 1, Moscow 119021



O. E. Egorov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, University Clinical Hospital Three

11, Rossolimo St., Build. 1, Moscow 119021



G. Yu. Evzikov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, University Clinical Hospital Three

11, Rossolimo St., Build. 1, Moscow 119021



T. I. Shadyzheva
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

A.Ya. Kozhevnikov Clinic of Nervous System Diseases, University Clinical Hospital Three

11, Rossolimo St., Build. 1, Moscow 119021



References

1. Davis MA, Onega T, Weeks WB, Lurie JD. Where the United States spends its spine dollars: expenditures on different ambulatory services for the management of back and neck conditions. Spine (Phila Pa 1976). 2012 Sep 1;37(19):1693-701. doi: 10.1097/brs.0b013e3182541f45

2. Hansen HC, McKenzie-Brown AM, Cohen SP, et al. Sacroiliac joint interventions: a systematic review. Pain Phys. 2007 Jan;10(1):165-84.

3. Schamberger W. The malaligment syndrome. Diagnosis and treating a common cause of acute and chronic pelvic, leg and back pain. 2 nd ed. Edinburgh: Churchill Livingstone; 2013.

4. Colo G, Cavagnaro L, Alessio-Mazzola M, et al. Incidence, diagnosis and management of sacroiliitis after spinal surgery: a systematic review of the literature. Musculoskelet Surg. 2019. doi: 10.1007/s12306-019-00607-0

5. Harvey A. Classification of Chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Clin J Pain. 1995;11(2):163. doi: 10.1097/00002508199506000-00024.

6. Fortin JD, Aprill CN, Ponthieux B, Pier J. Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part II: Clinical evaluation. Spine (Phila Pa 1976). 1994 Jul 1;19(13):1483-8. doi: 10.1097/00007632-199407000-00011

7. Fortin JD, Falco FJ. The Fortin finger test: an indicator of sacroiliac pain. Am J Orthop (Belle Mead NJ). 1997 Jul;26(7):477-80.

8. Slipman CW, Jackson HB, Lipetz JS, et al. Sacroiliac joint pain referral zones. Arch Phys Med Rehabil. 2000;81:334-8. doi: 10.1053/apmr.2000.0810334

9. Zelle BA, Gruen GS, Brown S, George S. Sacroiliac joint dysfunction. Clin J Pain. 2005;21:446-55. doi: 10.1097/01.ajp.0000131413.07468.8e

10. Dreyfuss P, Dryer S, Griffin J, et al. Positive sacroiliac screening tests in asymptomatic adults. Spine (Phila Pa 1976). 1994 May 15;19(10):1138-43. doi: 10.1097/00007632199405001-00007

11. Slipman CW, Lipetz JS, Plastaras CT, et al. Fluoroscopically guided therapeutic sacroiliac joint injections for sacroiliac joint syndrome. Am J Phys Med Rehabil. 2001 Jun;80(6):425-32. doi: 10.1097/00002060-200106000-00007

12. Cohen SP. Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesth Analg. 2005 Nov;101(5):1440-53. doi: 10.1213/01.ane.0000180831.60169.ea

13. Fortin JD, Dwyer AP, West S, Pier J. Sacroiliac joint: Pain referral maps upon applying a new injection/arthrography technique. Part I: Asymptomatic volunteers. Spine (Phila Pa 1976). 1994;19:1475-82. doi: 10.1097/00007632-199407000-00010

14. Cusi MF. Paradigm for assessment and treatment of SIJ mechanical dysfunction. J Bodyw Mov Ther. 2010 Apr;14(2):152-61. doi: 10.1016/j.jbmt.2009.12.004

15. Parfenov VA, Yakhno NN, Kukushkin ML, et al. Acute nonspecific (musculoskeletal) low back pain Guidelines of the Russian Society for the Study of Pain (RSSP). Nevrologiya, neyropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):4-11. doi: 10.14412/2074-2711-2018-2-4-11 (In Russ.).

16. Parfenov VA, Gerasimova ON. Treatment of nonspecific back pain in outpatient practice. Spravochnik poliklinicheskogo vracha = Outpatient Doctor's Directory. 2013;(1):48-51 (In Russ.).

17. Kuijpers T, van Middelkoop M, Rubinstein SM, et al. A systematic review on the effectiveness of pharmacological interventions for chronic non-specific low-back pain. Eur Spine J. 2011;20:40-50. doi: 10.1007/s00586-010-1541-4

18. Low Back Pain and Sciatica in Over 16s: Assessment and Management. National Institute for Health and Care Excellenc: Clinical Guidelines. London: National Institute for Health and Care Excellence (UK); 2016.

19. Airaksinen O, Brox JI, Cedraschi C, et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl. 2):S192-S300. doi: 10.1007/s00586-006-1072-1

20. Parfenov VA, Isaikin AI. Bol' v nizhney chasti spiny: mify i real'nost' [Lower back pain: myths and reality]. Moscow: IMA-PRESS; 2016 (In Russ.).

21. Manchikanti L, Abdi S, Atluri S. An Update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: Guidance and recommendations. Pain Physician. 2013;16:S49S283.

22. Kim WM, Lee HG, Jeong CW, et al. A randomized controlled trial of intra-articular prolotherapy versus steroid injection for sacroiliac joint pain. J Altern Complement Med. 2010;16:1285-90. doi: 10.1089/acm.2010.0031

23. Nacey NC, Patrie JT, Fox GM. Fluoroscopically guided sacroiliac joint injections: comparison of the effects of intraarticular and periarticular injections on immediate and short-term pain relief. AJR Am J Roentgenol. 2016 Nov;207(5):1055-61. doi: 10.2214/ajr.15.15779

24. Aydin SM, Gharibo CG, Mehnert M, Stitik TP. The role of radiofrequency ablation for sacroiliac joint pain: a meta-analysis. PM&R. 2010 Sep;2(9):842-51. doi: 10.1016/j.pmrj.2010.03.035

25. Cohen SP, Hurley RW, Chester C, et al. Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain. Anesthesiology. 2008 Aug;109(2):279-88. doi: 10.1097/aln.0b013e31817f4c7c

26. Smith HP, McWhorter JM, Challa VR. Radiofrequency neurolysis in a clinical model; neuropathological correlation. J Neurosurg. 1981;55:246-53. doi: 10.3171/jns.1981.55.2.0246

27. Cohen SP, Strassels SA, Kurihara C, et al. Outcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation. Reg Anesth Pain Med. 2009 May–Jun;34(3):206-14. doi: 10.1097/aap.0b013e3181958f4b

28. Gevargez A, Groenemeyer D, Schirp S, Braun M.CT guided percutaneous radiofrequency denervation of the sacroiliac joint. Eur Radiol. 2002 Jun;12(6):1360-5. doi: 10.1007/s00330-001-1257-2


For citation:


Belozerskikh K.A., Egorov O.E., Evzikov G.Yu., Shadyzheva T.I. Puncture technologies in the treatment of pain syndrome caused by sacroiliac joint dysfunction. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(4):32-36. (In Russ.) https://doi.org/10.14412/2074-2711-2020-4-32-36

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)