Sacroiliac joint pain after lumbar and lumbosacral fusion: findings using dual sacroiliac joint blocks.

OBJECTIVE

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.

DESIGN

Prospective cohort study.

PATIENTS AND METHODS

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.

OUTCOME MEASURES

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.

RESULTS

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).

CONCLUSIONS

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.