Article
Treatment of Sacroiliac Joint Pain with Peripheral Nerve Stimulation
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Published: | April 24, 2015 |
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Introduction: Sacroiliac joint (SIJ) pain affects older adults with a prevalence of up to 20% among patients with chronic low back pain. While pain medication, joint blocks and denervation procedures achieve pain relief in most patients some cases fail to improve. Our goal was to determine the effectiveness of SIJ peripheral nerve stimulation in patients with severe conservative therapy-refractory SIJ pain.
Material and methods: Here we present 12 patients with severe conservative therapy-refractory pain receiving a SIJ peripheral nerve stimulation. Patient satisfaction, pain and quality of life was evaluated by means of the International Patient Satisfaction Index (IPSI), Visual Analog Scale (VAS) and Oswestry Disability Index 2.0 (ODI) using standard questionnaires. For stimulation we placed an 8 pole peripheral nerve electrode parallel to the SIJ.
Results: Two weeks postoperatively our patients reported an average ODI reduction from 57% to 32% and VAS from 9 to 2.1. IPSI was 1.1. After six months the therapy was rated as effective in 7 out of 8 patients reporting at that period. The average ODI was low 34% (p=0.0006) while the VAS index rose to 3.8 (p<0.0001) and IPSI to 1.9. Twelve months after stimulation 6 out of 7 patients considered their treatment a success with an average ODI of 21% (p<0.0005), VAS 1,7 (p<0.0001) and IPSI 1.3.
Conclusion: We conclude that SIJ stimulation is a promising therapeutic strategy in the treatment of intractable SIJ pain. Further studies are required to determine the precise target group and long-term effect of this novel treatment method.