Buchanan Patrick, Lee David W, Comer Ashley, Hussaini Zohra, Grillo Casey, Vodapally Shashank, Strand Natalie H, Sayed Dawood, Deer Timothy R
Department of Pain Medicine, Spanish Hills Interventional Pain Specialists, Camarillo, CA, USA.
Department of Pain Medicine, Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA.
J Pain Res. 2022 Apr 19;15:1149-1162. doi: 10.2147/JPR.S357123. eCollection 2022.
Sacroiliac joint (SIJ) pain is a common cause of low back pain. Traditionally, treatment for SIJ joint pain and dysfunction has consisted of physical therapy, medication management, SIJ injections, and SIJ ablations. Improved recognition of the SIJ as an etiology for back pain has led to advances in treatment options. Radiofrequency of the lateral sacral branches has been shown to be effective, though evidence is fraught with inconsistent patient selection, study design and procedural technique. It also does not directly address the mechanical dysfunction of the SIJ. In order to create a more enduring approach SIJ fusion has become an attractive option to reduce pain and to improve function. This method of SI joint treatment requires guidance in the perioperative phase of care from both the physicians and advanced practice providers (APP). In order to improve care and outcomes of those undergoing posterior SI joint fusion the American Society of Pain and Neuroscience appointed an expert panel of physicians and advanced practice providers to create a best practice for the post operative care of this approach. As with any best practice, the panel considered current peer reviewed literature and clinical expertise to create guidance today. This is intended to be a living document with modifications as additional evidence comes to light in data publication. The goals of this paper are to focus on (1) wound care, (2) medication use, (3) physical activity and (4) therapeutic exercises.
骶髂关节(SIJ)疼痛是下背痛的常见原因。传统上,骶髂关节疼痛和功能障碍的治疗方法包括物理治疗、药物管理、骶髂关节注射和骶髂关节消融术。对骶髂关节作为背痛病因的认识不断提高,推动了治疗选择的进步。尽管证据因患者选择、研究设计和手术技术不一致而充满争议,但骶外侧分支的射频治疗已被证明是有效的。它也不能直接解决骶髂关节的机械功能障碍。为了创造一种更持久的治疗方法,骶髂关节融合术已成为减轻疼痛和改善功能的有吸引力的选择。这种骶髂关节治疗方法在围手术期护理阶段需要医生和高级实践提供者(APP)的指导。为了改善接受后路骶髂关节融合术患者的护理和治疗效果,美国疼痛与神经科学协会任命了一个由医生和高级实践提供者组成的专家小组,为这种治疗方法的术后护理制定最佳实践方案。与任何最佳实践一样,该小组参考了当前经过同行评审的文献和临床专业知识来制定当下的指导方针。随着更多数据公布后有新的证据出现,本文旨在成为一份可修改的实用文件。本文的目标是关注(1)伤口护理、(2)药物使用、(3)身体活动和(4)治疗性锻炼。
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