Rocky Vista University College of Osteopathic Medicine, 8401 S. Chambers Rd, Parker, CO 80134, USA.
Star Spine and Sport, 2801 Youngfield St, Suite 150, Golden, CO 80401, USA.
Mil Med. 2020 Aug 14;185(7-8):e1312-e1317. doi: 10.1093/milmed/usz398.
Back pain and its associated complications are of increasing importance among military members. The sacroiliac joint (SIJ) is a common source of chronic low back pain (LBP) and functional disability. Many patients suffering from chronic LBP utilize opioids to help control their symptoms. Platelet-rich plasma (PRP) has been used extensively to treat pain emanating from many different musculoskeletal origins; however, its use in the SIJ has been studied only on a limited basis. The patient in this case report presented with chronic LBP localized to the SIJ and subsequent functional disability managed with high-dose opioids. After failure of traditional treatments, she was given an ultrasound-guided PRP injection of the SIJ which drastically decreased her pain and disability and eventually allowed for complete opioid cessation. Her symptom relief continued 1 year after the injection. This case demonstrates the potential of ultrasound-guided PRP injections as a long-term treatment for chronic LBP caused by SIJ dysfunction in military service members, which can also aid in the weaning of chronic opioid use.
背痛及其相关并发症在军人中越来越重要。骶髂关节(SIJ)是慢性下背痛(LBP)和功能障碍的常见原因。许多患有慢性 LBP 的患者使用阿片类药物来帮助控制症状。富含血小板的血浆(PRP)已被广泛用于治疗源自许多不同肌肉骨骼来源的疼痛;然而,它在 SIJ 中的使用仅在有限的基础上进行了研究。本病例报告中的患者表现为慢性 LBP 局限于 SIJ,随后出现功能障碍,用高剂量阿片类药物治疗。在传统治疗失败后,她接受了超声引导下的 SIJ PRP 注射,这大大减轻了她的疼痛和残疾,并最终使她能够完全停止使用阿片类药物。注射后 1 年,她的症状仍持续缓解。该病例表明,超声引导下的 PRP 注射可能是治疗因 SIJ 功能障碍引起的慢性 LBP 的长期治疗方法,也有助于减少慢性阿片类药物的使用。