Nayak Bibhu K, Singh Dharmendra K, Kumar Nishith, Jaiswal Binita
Department of Sports Medicine, Sports Injury Centre, New Delhi, India.
Department of Radiodiagnosis, VMMC and Safdarjung Hospital, New Delhi, India.
Indian J Radiol Imaging. 2020 Oct-Dec;30(4):448-452. doi: 10.4103/ijri.IJRI_382_19. Epub 2021 Jan 13.
Iliolumbar syndrome is a frequent cause of chronic nonspecific low back pain. The cornerstone of its treatment lies upon the specific diagnosis of the iliolumbar syndrome. The ultrasound guided interventions have the potential for the specific diagnosis and treatment of the iliolumbar syndrome.
To assess the role of ultrasound-guided intervention for the diagnosis and treatment of the iliolumbar syndrome.
The study comprised of fifty-seven patients of nonspecific low back pain with the clinically suspected iliolumbar syndrome. Two-staged ultrasound-guided interventions were performed: Primary diagnostic and secondary therapeutic interventions. Favorable response after the injection of local anesthetic agent in iliolumbar ligament (defined as VAS score to ≥3) was classified as confirmed Ilio-lumbar syndrome. Clinico radiological efficacy after platelet-rich plasma (PRP) injection in confirmed iliolumbar syndrome patients was done.
Out of 57 patients, 45 (78.95%) were diagnosed with confirmed Iliolumbar syndrome after primary diagnostic intervention. The mean value of VAS at presentation was 8.02 ± 0.72 which was decreased to 3.16 ± 1.63; < 0.0001. All 45 patients underwent PRP injection in iliolumbar ligament and 42 patients (93.33%) showed reduction in mean VAS score from 8 ± 0.67 (at presentation) to 0.89 ± 1.23 after 6 weeks follow up; < 0.0001. Iliolumbar ligament thickness was decreased from the day of presentation (2.66 ± 0.22) to 6 weeks after therapeutic intervention (0.91 ± 0.42); < 0.0001.
The ultrasound guided diagnostic and therapeutic intervention were found to result in a specific diagnosis and remarkable recovery in the iliolumbar syndrome group of nonspecific low back pain patients.
髂腰综合征是慢性非特异性下腰痛的常见病因。其治疗的关键在于对髂腰综合征的明确诊断。超声引导下的干预措施对髂腰综合征具有明确诊断和治疗的潜力。
评估超声引导下的干预措施在髂腰综合征诊断和治疗中的作用。
该研究纳入了57例临床疑似髂腰综合征的非特异性下腰痛患者。实施了两阶段的超声引导下干预：初步诊断性干预和后续治疗性干预。在髂腰韧带注射局部麻醉剂后出现良好反应（定义为视觉模拟评分法（VAS）评分提高≥3分）被归类为确诊的髂腰综合征。对确诊为髂腰综合征的患者注射富血小板血浆（PRP）后的临床放射学疗效进行了评估。
57例患者中，45例（78.95%）在初步诊断性干预后被诊断为确诊的髂腰综合征。就诊时VAS的平均值为8.02±0.72，降至3.16±1.63；P<0.0001。所有45例患者均在髂腰韧带注射了PRP，42例患者（93.33%）在随访6周后平均VAS评分从就诊时的8±0.67降至0.89±1.23；P<0.0001。髂腰韧带厚度从就诊时的（2.66±0.22）降至治疗干预6周后的（0.91±0.42）；P<0.0001。
超声引导下的诊断和治疗性干预在非特异性下腰痛患者的髂腰综合征组中实现了明确诊断和显著康复。
