Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA.
Spanish Hills Interventional Pain Specialists, Camarillo, CA, USA.
Pain Res Manag. 2022 Aug 22;2022:3312589. doi: 10.1155/2022/3312589. eCollection 2022.
Sacroiliac (SI) joint arthropathy is the primary pain generator in approximately 15-25% of patients with axial low back pain and traditionally diagnosed with >50% pain reduction following an intra-articular injection localized to the inferior 1/3 of the SI joint. The conventional technique for accessing the SI joint encompasses a posterior approach with fluoroscopic guidance at 10-20⁰ contralateral oblique angulation, and minor adjustments to this approach have been implemented with varying degrees of success. The authors present a novel technique for SI joint injection, infiltrating the middle third of the joint through an alternative far-contralateral oblique (FCO) approach, angulation between 20-40⁰. This approach theoretically endows easier access to the SI joint and at the very least provides another option for interventionalists in the diagnosis and treatment of sacroiliac joint pain. It can also be utilized to determine if a patient is a candidate for posterior percutaneous SI joint fusion. The authors sought to document this approach to ensure that it was both reproducible and safe, while recognizing the need for future studies.
骶髂（SI）关节病变是大约 15-25%的轴向腰痛患者的主要疼痛源，传统上认为在关节内注射后，疼痛会减轻>50%，注射部位位于 SI 关节的下 1/3 处。传统的 SI 关节入路方法为后路入路，在 10-20°对侧斜向角下进行透视引导，并且已经对该方法进行了一些微小的调整，取得了不同程度的成功。作者提出了一种新的 SI 关节注射技术，通过一种替代的远对侧斜（FCO）入路，在 20-40°的角度下渗透到关节的中间三分之一。该方法理论上可以更容易地进入 SI 关节，至少为介入治疗师在诊断和治疗骶髂关节疼痛方面提供了另一种选择。它也可以用于确定患者是否适合进行后路经皮 SI 关节融合术。作者旨在记录该方法，以确保其具有可重复性和安全性，同时认识到需要进一步的研究。
