Department of Neurosurgery, I-Shou University, Kaohsiung, Taiwan.
Pain Med. 2011 Apr;12(4):565-70. doi: 10.1111/j.1526-4637.2011.01087.x. Epub 2011 Apr 4.
The present study was performed to ascertain whether sacroiliac joint (SIJ) pain represents a potential source of pain in patients who have undergone lumbar or lumbosacral fusions.
Prospective cohort study.
Between June 2007 and June 2009, 130 patients who underwent lumbar or lumbosacral fusions were evaluated for SIJ pain. Fifty-two patients for whom positive findings were obtained on at least three of the provocating tests for SIJ pain were selected to receive dual diagnostic blocks.
A positive response was defined as characteristic pain reduction of 75% for 1-4 hours following the SIJ blocks. Predictive factors for a positive response to the SIJ blocks were also investigated.
Among the 52 patients, 21 were considered to have SIJ pain on the basis of two positive responses to diagnostic blocks. Univariate analysis revealed that the predictive factors related to positive responses were unilateral pain (P = 0.002), more than three positive responses to provocating maneuvers (P = 0.02), and postoperative pain with characteristics different from those of preoperative pain (P = 0.04).
SIJ pain is a potential source of pain after lumbar and lumbosacral fusion surgeries. Provocating SIJ maneuvers represent reliable tests for SIJ pain. The characteristics of postoperative SIJ pain frequently differ from those of preoperative pain.
本研究旨在确定骶髂关节（SIJ）疼痛是否代表接受腰椎或腰骶融合术患者的潜在疼痛源。
前瞻性队列研究。
2007 年 6 月至 2009 年 6 月，对 130 例接受腰椎或腰骶融合术的患者进行了 SIJ 疼痛评估。对至少三项 SIJ 疼痛激发试验阳性的 52 例患者选择进行双诊断阻滞。
阳性反应定义为 SIJ 阻滞后 1-4 小时内疼痛减轻 75%。还研究了 SIJ 阻滞阳性反应的预测因素。
在 52 例患者中，有 21 例根据诊断性阻滞的两次阳性反应被认为存在 SIJ 疼痛。单因素分析显示，与阳性反应相关的预测因素包括单侧疼痛（P=0.002）、激发试验阳性超过 3 次（P=0.02）和术后疼痛与术前疼痛特征不同（P=0.04）。
SIJ 疼痛是腰椎和腰骶融合术后疼痛的潜在来源。激发 SIJ 试验是诊断 SIJ 疼痛的可靠方法。术后 SIJ 疼痛的特征常与术前疼痛不同。
