Das Gautam, Das Suspa, Sahoo Rajendra, Shreyas Sneha, Kanthi Basabraj, Sharma Vikas S
Daradia Pain Hospital, Kolkata, West Bengal, India.
Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Indian J Anaesth. 2023 Nov;67(11):1004-1008. doi: 10.4103/ija.ija_938_22. Epub 2023 Nov 7.
Intra-articular steroids provide significant pain relief in sacroiliac joint pain (SIJP), but their action is short-lived. Cryoneurolysis is reported to produce prolonged pain relief in various pain conditions. However, its efficacy has not been evaluated in patients with SIJP. Thus, we compared the efficacy of cryoneurolysis with steroid injections in adult patients with SIJP.
This retrospective healthcare records review-based study involved 83 patients with SIJP. Patients were divided into two groups: cases (sacroiliac joint [SIJ] cryoneurolysis, = 39) and controls (SIJ steroid injection, = 44). An 11-point numeric pain rating scale (NPRS) was used to assess the pain severity at baseline and immediately, 1, 3 and 6 months post-intervention. A reduction of ≥50% in NPRS score immediately following SIJ cryoneurolysis and steroid injection was considered a successful outcome. The difference between the treatment groups was assessed with a Chi-square test, and < 0.05 was considered statistically significant.
Both cases and controls showed significantly decreased NPRS scores from baseline to immediately, 1 month, 3 months and 6 months postintervention ( < 0.001). However, compared to controls, cases had significantly lower NPRS scores at all time points (all < 0.001). Moreover, a significantly greater proportion of cases had ≥50% decrease in NPRS score from baseline, that is, 1 month (97.44% vs. 75%, = 0.004), 3 months (100% vs. 47.73%, < 0.001) and 6 months (69.23% vs. 27.27%, < 0.001).
Although both cryoneurolysis and intra-articular steroid injections provide significant pain relief immediately, 1, 3 and 6 months postintervention, cryoneurolysis resulted in significantly greater pain relief.
关节内注射类固醇可显著缓解骶髂关节疼痛(SIJP),但其作用持续时间较短。据报道,冷冻神经lysis在各种疼痛情况下均可产生持久的疼痛缓解效果。然而,其在SIJP患者中的疗效尚未得到评估。因此,我们比较了冷冻神经lysis与类固醇注射对成年SIJP患者的疗效。
这项基于回顾性医疗记录的研究纳入了83例SIJP患者。患者分为两组:病例组(骶髂关节[SIJ]冷冻神经lysis,n = 39)和对照组(SIJ类固醇注射,n = 44)。采用11点数字疼痛评分量表(NPRS)在基线时以及干预后即刻、1个月、3个月和6个月评估疼痛严重程度。SIJ冷冻神经lysis和类固醇注射后NPRS评分立即降低≥50%被视为成功结果。用卡方检验评估治疗组之间的差异,P < 0.05被认为具有统计学意义。
病例组和对照组从基线到干预后即刻、1个月、3个月和6个月的NPRS评分均显著降低(P < 0.001)。然而,与对照组相比,病例组在所有时间点的NPRS评分均显著更低(均P < 0.001)。此外,病例组中NPRS评分从基线降低≥50%的比例显著更高,即1个月时(97.44%对75%,P = 0.004)、3个月时(100%对47.73%,P < 0.001)和6个月时(69.23%对27.27%,P < 0.001)。
尽管冷冻神经lysis和关节内类固醇注射在干预后即刻、1个月、3个月和6个月均能显著缓解疼痛,但冷冻神经lysis带来的疼痛缓解效果显著更佳。