Ab Aziz Siti Nur Fudhlana, Zakaria Mohamad Zamzuri, Karupiah Rajandra Kumar, Che Ahmad Aminudin, Omar Ahmad Sabri
Orthopedics, Hospital Tengku Ampuan Afzan, Kuantan, MYS.
Orthopedics, Traumatology and Rehabilitation, International Islamic University Malaysia, Kuantan, MYS.
Cureus. 2022 Apr 11;14(4):e24039. doi: 10.7759/cureus.24039. eCollection 2022 Apr.
Sacroiliac joint injection aims to provide pain relief, improve work status, and early return to work. We aimed to investigate the role of corticosteroid and anesthetic mixture to provide short- and long-term pain relief in patients with sacroiliac joint pain. This prospective observational study included 27 patients with sacroiliac joint dysfunction who received a combination of triamcinolone and ropivacaine for sacroiliac joint injection followed by three scheduled visits at four weeks, eight weeks, and six months. The pain was assessed using visual analogue scale (VAS), physician's assessment on the number of positive provocative tests, and patients' self-reported assessment to evaluate their functional outcome. At the four weeks and eight weeks follow up evaluations, the mean VAS reduced from 5.85 (±1.03) at baseline to 3.30 (±1.77) at four weeks, 3.30 (±1.86) at eight weeks, and 3.00 (±1.86) at six months. At each interval, improvement in terms of clinical assessment using a series of provocative tests was seen with a mean of 1.37 (±1.33), 1.63 (±1.31), and 1.48 (±1.05) at four weeks, eight weeks, and six months, respectively. For the functional effectiveness parameters (Roland-Morris questionnaires), the sacroiliac joint (SIJ) injected with these drugs combination showed a more significant improvement in symptoms and function, baseline (13.56±3.36), at four weeks (9.04±3.33), at eight weeks (9.07±4.13), and six months (8.26±4.92). Using the one-way repeated measures ANOVA, the SIJ pain, provocative test, and functional outcome significantly improved over time after injection with triamcinolone and ropivacaine (p<0.001). No complications of the administration of these medications were noted. Our findings support the intermediate-term (six months) effectiveness and safety of a combination of corticosteroid and anesthetic injection for patients with SIJ dysfunction who failed conservative treatment.
骶髂关节注射旨在缓解疼痛、改善工作状态并尽早恢复工作。我们旨在研究皮质类固醇和麻醉剂混合物在为骶髂关节疼痛患者提供短期和长期疼痛缓解方面的作用。这项前瞻性观察性研究纳入了27例骶髂关节功能障碍患者，他们接受了曲安奈德和罗哌卡因联合进行骶髂关节注射，随后在四周、八周和六个月进行了三次预定随访。使用视觉模拟量表（VAS）评估疼痛，由医生评估阳性激发试验的数量，并通过患者自我报告评估来评估其功能结果。在四周和八周的随访评估中，平均VAS从基线时的5.85（±1.03）降至四周时的3.30（±1.77）、八周时的3.30（±1.86）和六个月时的3.00（±1.86）。在每个时间间隔，通过一系列激发试验进行的临床评估均有改善，四周、八周和六个月时的平均值分别为1.37（±1.33）、1.63（±1.31）和1.48（±1.05）。对于功能有效性参数（罗兰-莫里斯问卷），注射这些药物组合的骶髂关节（SIJ）在症状和功能方面有更显著改善，基线时为（13.56±3.36），四周时为（9.04±3.33），八周时为（9.07±4.13），六个月时为（8.26±4.92）。使用单向重复测量方差分析，注射曲安奈德和罗哌卡因后，骶髂关节疼痛、激发试验和功能结果随时间显著改善（p<0.001）。未观察到这些药物给药的并发症。我们的研究结果支持皮质类固醇和麻醉剂联合注射对保守治疗无效的骶髂关节功能障碍患者的中期（六个月）有效性和安全性。
