Liu Yanting, Suvithayasiri Siravich, Kim Jin-Sung
Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Orthopedics, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
Neurospine. 2023 Sep;20(3):997-1010. doi: 10.14245/ns.2346586.293. Epub 2023 Sep 30.
We aimed to identify the most effective clinical treatment method for sacroiliac joint (SIJ)-related pain based on the systematic review and network meta-analysis (NMA) to evaluate the comparative efficacy of clinical interventions for sacroiliac joint pain by pooling the randomized controlled trials (RCTs).
Our team conducted a systematic review and NMA of RCTs to determine the most effective clinical treatment for SIJ-related pain. We searched the PubMed (MEDLINE), Web of Science, Cochrane Library, and Scopus databases for RCTs until February 2023. The PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines were followed. Pairwise and network meta-analyses were conducted using a random effects model.
Based on the search strategy and inclusion criteria, our systematic review and NMA included 9 randomized studies with 652 participants. Research has mainly focused on various radiofrequency sources, but their number is still low. In the network analysis, according to the NMA and mean ranking probabilities for the improvement of pain intensity (PI) and quality of life (QoL), sacroiliac joint fusion and cooled radiofrequency were associated with high treatment rank for improving PI and QoL in patients with sacroiliac joint pain.
This NMA suggest that SIJ fusion and cooled radiofrequency could be potential options for improving the QoL and relieving pain in patients with SIJ-related pain. Comparison studies of outcomes between these 2 procedures with solid methodology and a low risk of bias would be very beneficial to identify the optimal treatment option for this challenging disease.
我们旨在基于系统评价和网状Meta分析（NMA）确定治疗骶髂关节（SIJ）相关疼痛最有效的临床治疗方法，通过汇总随机对照试验（RCT）来评估骶髂关节疼痛临床干预措施的比较疗效。
我们的团队对RCT进行了系统评价和NMA，以确定治疗SIJ相关疼痛最有效的临床治疗方法。我们在PubMed（MEDLINE）、科学网、Cochrane图书馆和Scopus数据库中检索RCT，检索截至2023年2月。遵循PRISMA（系统评价和Meta分析的首选报告项目）指南。采用随机效应模型进行成对和网状Meta分析。
根据检索策略和纳入标准，我们的系统评价和NMA纳入了9项随机研究，共652名参与者。研究主要集中在各种射频源，但数量仍然较少。在网状分析中，根据NMA以及疼痛强度（PI）和生活质量（QoL）改善的平均排序概率，骶髂关节融合术和冷射频在改善骶髂关节疼痛患者的PI和QoL方面具有较高的治疗排名。
这项NMA表明，骶髂关节融合术和冷射频可能是改善骶髂关节相关疼痛患者生活质量和缓解疼痛的潜在选择。采用方法可靠且偏倚风险低的这两种手术之间的结果比较研究，对于确定这种具有挑战性疾病的最佳治疗选择将非常有益。
