背景:虽然严重骶髂关节(SIJ)疼痛是下背痛的常见原因,SIJ疾病通常被忽略为诊断。
目的:本研究检查了接受热凝治疗的SIJ综合征患者的长期疼痛缓解和功能改善的程度。一些接受热凝治疗的患者注意到初步改善,但功能和疼痛缓解的持续时间和疗效有限.建议改善不足的患者接受融合手术,以获得更好,更持久的结果。
方法:选择有长期背部或骨盆问题病史的患者进行研究。进行了SIJ的内窥镜热凝固。随访检查在1、3、6、12个月后进行。在热凝后疼痛缓解和功能不足的患者中,进行了融合手术.在12个月的随访期内记录了融合手术的结果。实施统计评价视觉模拟量表(VAS),记录Oswestry-Disability-Index(ODI)和阿片类药物的消费量。
结果:纳入48例患者。热凝后12个月的平均VAS值为68.9。12个月后的ODI非常接近或略高于热凝固前的基线。因此,建议进行融合手术.33名患者同意融合手术。融合手术后12个月的VAS值降至53.1。类似于VAS值,融合手术后Oswestry指数(ODI)显着改善。
结论:在热凝固12个月后效果不佳的SIJ综合征患者中,88%的手术干预成功证明了SIJ融合手术的优越性。这项研究表明,长期疼痛缓解平均为65%,功能损害的中位数改善为60%。鉴于这些结果,对于热凝固术没有足够成功的患者,应考虑进行融合手术。
BACKGROUND: While pain in the severe sacroiliac joint (
SIJ) is a common cause of lower back pain,
SIJ disease is often overlooked as a diagnosis.
OBJECTIVE: This study examines the extent of sufficient long-term pain relief and functional improvement in patients with
SIJ syndrome that are treated with thermocoagulation. Some patients treated with thermocoagulation noted initial improvement, but the functionality and pain relief had limited duration and efficacy. Patients with insufficient improvement were recommended to undergo fusion surgery as an option for better and longer lasting results.
METHODS: Patients with a long history of back or pelvic problems were selected for the study. Endoscopic thermal coagulation of the
SIJ was carried out. The follow-up examinations took place after 1, 3, 6, 12 months. In patients with insufficient pain relief and functionality after thermocoagulation, a fusion surgery was performed. The results of the fusion surgery were documented over a 12-month follow-up period. To carry out the statistical evaluation visual analog scale (VAS), Oswestry-Disability-Index (ODI) and the consumption of opioids were recorded.
RESULTS: Forty-eight patients were included. The mean VAS values 12 months after thermocoagulation were 68.9. The ODI after 12 months was very near or somewhat higher than their baseline prior to the thermocoagulation. Thus, a fusion surgery was recommended. Thirty-three patients agreed to the fusion operation. The VAS values 12 months after fusion surgery decreased to 53.1. Analogous to the VAS values, the Oswestry index (ODI) showed a significant improvement after the fusion operation.
CONCLUSIONS: The success of surgical intervention in 88% of the SIJ syndrome patients with inadequate results 12 months after thermocoagulation proves the superiority of
SIJ fusion surgery. This study showed long-lasting pain relief by an average of 65% and a median improvement in functional impairments of 60%. In view of these results, fusion surgery should be considered for patients without sufficient success of thermocoagulation.