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Interventional medicine techniques in the treatment of nonspecific low back pain caused by sacroiliac joint dysfunction

https://doi.org/10.14412/2074-2711-2018-2-33-37

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Abstract

Objective: to investigate the efficiency and safety of therapeutic blockades with anesthetics and GCs, or SIJ RFD in the combination therapy of chronic low back pain due to SIJ injury.

Patients and methods. The investigation enrolled 51 patients (36 women and 15 men) aged 32 to 75 years (mean age, 56.4±2.1 years). Group 1 included 32 patients (mean age, 51.75±2.65 years) who used periarticular blockades with local anesthetics and GCs; Group 2 consisted of 19 patients (mean age, 64.1±2.8 years) who underwent SIJ RFD.

Results and discussion. These treatments showed high efficiency and safety. Three months after a treatment cycle, there were reductions in the intensity of pain (by an average of 47%; p<0.0001) and in the degree of disability and improvements in the physical and psychological parameters of quality of life. There were no substantial differences in the health status of patients in the two groups treated with blockades with anesthetics and GCs or SIJ RFD.

Conclusion. It has been shown that the incorporation of blockades with anesthetics and GCs or SIJ RFD into the treatment of patients with chronic low back pain can improve the results of therapy. 

About the Authors

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

Department of Nervous System Diseases and Neurosurgery 

11, Rossolimo St., Moscow 119021



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

Contact: Aleksey Ivanovich Isaikin 

Department of Nervous System Diseases and Neurosurgery 

11, Rossolimo St., Moscow 119021



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

Department of Nervous System Diseases and Neurosurgery 

11, Rossolimo St., Moscow 119021



References

1. Parfenov VA, Isaikin AI. Bol' v nizhnei chasti spiny: mify i real'nost' [Lower back pain: myths and reality]. Moscow: IMA-PRESS; 2016. P. 8-12.

2. DePalmaMJ, KetchumJM, SaulloT. What is the source of chronic low back pain and does age play a role? Pain Med. 2011 Feb;12(2): 224-33. doi: 10.1111/j.1526-4637.2010.01045.x. Epub 2011 Jan 25.

3. Laplante BL, Ketchum JM, Saullo TR, DePalma MJ. Multivariable analysis of the relationship between pain referral patterns and the source of chronic low back pain. Pain Physician. 2012 Mar-Apr;15(2):171-8.

4. Polsunas PJ, Sowa G, Fritz JM, et al. Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and ExpertBased Recommendations for Evaluation and Treatment: Part X: Sacroiliac Joint Syndrome. Pain Med. 2016 Sep;17(9):1638-47. doi: 10.1093/pm/pnw151.

5. Amirdelfan K, McRoberts P, Deer T. The Differential Diagnosis of Low Back Pain: A Primer on the Evolving Paradigm. Neuromodulation. 2014 Oct;17 Suppl 2:11-7. doi: 10.1111/ner.12173.

6. Allegri M, Montella S, Salici F, et al. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Res. 2016 Jun 28 [revised 2016 Oct 11];5. pii: F1000 Faculty Rev1530. eCollection 2016.

7. Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother. 2013 Jan;13(1):99-116. doi: 10.1586/ern.12.148.

8. Itz C, Willems P, Zeilstra D, Huygen F. Dutch Multidisciplinary Guideline for Invasive Treatment of Pain Syndromes of the Lumbosacral Spine. Pain Pract. 2016 Jan;16(1):90-110. doi: 10.1111/papr.12318. Epub 2015 Jun 1.

9. Simopoulos TT, Manchikanti L, Gupta S. Systematic Review of the Diagnostic Accuracy and Therapeutic Effectiveness of Sacroiliac Joint Interventions. Pain Physician. 2015 Sep–Oct;18(5):E713-56.

10. Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low-back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478-91.

11. Poley RE, Borcher JR. Sacroiliac Joint Dysfunction: Evaluation and Treatment. Phys Sportsmed. 2008 Dec;36(1):42-9. doi: 10.3810/psm.2008.12.10.

12. Lee J, Gupta S, Price C, Baranowski AP; British Pain Society. Low back and radicular pain: a pathway for care developed by the British Pain Society. Br J Anaesth. 2013 Jul; 111(1):112-20. doi: 10.1093/bja/aet172.

13. Manchikanti L, Falco FJ, Singh V, et al. Utilization of interventional techniques in managing chronic pain in the Medicare population: Analysis of growth patterns from 2000 to 2011. Pain Physician. 2012 Nov-Dec;15(6):E969-82.

14. Low Back Pain and Sciatica in Over 16s: Assessment and Management. London: National Institute for Health and Care Excellence; 2016.

15. Koes B, Van Tulder M, Chung-Wei CL. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J 2010; 19:2075-94 for Clinical Management of Chronic Spinal Pain. Pain Physician. 2009 Jul-Aug;12(4): E225-64.

16. Manchikanti L, Abdi S, Atluri S, Benyamin RM, et al. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician. 2013 Apr;16(2 Suppl):S49-283.

17. King W, Ahmed SU, Baisden J, et al. Diagnosis and treatment of posterior sacroiliac complex pain: A systematic review with comprehensive analysis of the published data. Pain Med. 2015 Feb;16(2):257-65. doi: 10.1111/pme.12630.

18. Nacey NC, Patrie JT, Fox MG. 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):1055-1061. Epub 2016 Aug 30.

19. Murakami E, Tanaka Y, Aizawa T, et al. Effect of periarticular and intraarticular lidocaine injections for sacroiliac joint pain: prospective comparative study. J Orthop Sci. 2007 May;12(3):274-80. Epub 2007 May 31.

20. Schneider BJ, Huynh L, Levin J, et al. Does Immediate Pain Relief After an Injection into the Sacroiliac Joint with Anesthetic and Corticosteroid Predict Subsequent Pain Relief. Pain Med. 2018 Feb 1;19(2):244-251. doi: 10.1093/pm/pnx104.

21. Leggett LE, Soril LJ, Lorenzetti DL, et al. Radiofrequency ablation for chronic low back pain: a systematic review of randomized controlled trials. Pain Res Manag. 2014 Sep–Oct;19(5):e146-53. Epub 2014 Jul 28.

22. Parfenov VA, Golovacheva VA. Khronicheskaya bol' i ee lechenie v nevrologii [Chronic pain and its treatment in neurology]. Moscow: GeotarMedia; 2018. 280 p.


For citation:


Kavelina A.V., Isaikin A.I., Ivanova M.A. Interventional medicine techniques in the treatment of nonspecific low back pain caused by sacroiliac joint dysfunction. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):33-37. (In Russ.) https://doi.org/10.14412/2074-2711-2018-2-33-37

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ISSN 2074-2711 (Print)
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