Patel Anurag, Kumar Dileep, Singh Shailendra, Mohan Ravindra, Mishra Sudhir, Gupta Anil K, Yadav Ganesh
Orthopaedics, Maa Vindhyawasini Autonomous State Medical College & Associated Divisional District Hospital, Mirzapur, IND.
Physical Medicine and Rehabilitation, King George's Medical University, Lucknow, IND.
Cureus. 2023 Mar 20;15(3):e36406. doi: 10.7759/cureus.36406. eCollection 2023 Mar.
Background Sacroiliac joint dysfunction is a major cause of axial low back pain which can masquerade as pain from lumbar disc diseases. Treatment of axial back pain arising due to sacroiliac joint dysfunction remains a challenge. This study was conducted to evaluate the long and short-term effects of intra-articular corticosteroid injection in the relief of pain and disability caused by sacroiliac joint dysfunction. Methodology A total of 83 patients with sacroiliac joint dysfunction were included in this prospective randomized control study. Patients were randomized into two groups by a computer-generated randomization table. These two groups were treated with fluoroscopy-guided corticosteroid and local anesthetic injection (group A) and distilled water and local anesthetic injection (group B). Pre and post-intervention assessment of all patients was done based on the Numeric Pain Rating Scale (NPRS) for pain and Oswestry Disability Index (ODI) for disability. The outcome measures of the study were the NPRS and ODI assessed at the initial visit one (pre-injection), two weeks post-injection (visit 2), and four weeks post-injection (visit 3). Results Demographic data were comparable in both groups. There was no significant difference in pre-injection NPRS and ODI values in both groups. The changes in NPRS and ODI values were significant from pre-injection to two weeks to four weeks. Group A patients performed better in terms of a decrease in the perception of pain and a decrease in the perception of disability compared to group B patients in the second and fourth weeks of follow-up. Conclusions Fluoroscopy-guided corticosteroid injection is an effective measure for reducing pain and disability in patients with sacroiliac joint dysfunction.
骶髂关节功能障碍是导致轴向性下腰痛的主要原因，这种疼痛可能会被误诊为腰椎间盘疾病引起的疼痛。治疗由骶髂关节功能障碍引起的轴向性背痛仍然是一项挑战。本研究旨在评估关节内注射皮质类固醇对缓解骶髂关节功能障碍所致疼痛和功能障碍的长期和短期效果。
本前瞻性随机对照研究共纳入83例骶髂关节功能障碍患者。通过计算机生成的随机表将患者随机分为两组。这两组分别接受荧光透视引导下的皮质类固醇和局部麻醉剂注射（A组）以及蒸馏水和局部麻醉剂注射（B组）。所有患者在干预前后均根据数字疼痛评分量表（NPRS）评估疼痛情况，并根据奥斯威斯利功能障碍指数（ODI）评估功能障碍情况。本研究的结局指标是在首次就诊（注射前）、注射后两周（就诊2）和注射后四周（就诊3）时评估的NPRS和ODI。
两组的人口统计学数据具有可比性。两组注射前的NPRS和ODI值均无显著差异。从注射前到两周再到四周，NPRS和ODI值的变化具有显著性。在随访的第二周和第四周，与B组患者相比，A组患者在疼痛感知降低和功能障碍感知降低方面表现更好。
荧光透视引导下的皮质类固醇注射是减轻骶髂关节功能障碍患者疼痛和功能障碍的有效措施。
