Kristoff Tyler J, Sinopoli Jacob T, Farley Tyler, Rabah Nicholas, Thompson Nicolas R, Goyal Kush
J. Willis Hurst Internal Medicine Residency Program, Emory University School of Medicine, Atlanta, USA.
Case Western Reserve University School of Medicine, Health Education Campus, 9501 Euclid Ave, Cleveland, OH, 44106, United States.
Interv Pain Med. 2023 Aug 1;2(3):100269. doi: 10.1016/j.inpm.2023.100269. eCollection 2023 Sep.
The goal of this project is to evaluate the therapeutic effectiveness of fluoroscopically guided intra-articular sacroiliac (SI) joint injections in patients with diagnosed SI joint dysfunction. Patient reported outcomes related to pain and quality of life measures were evaluated.
This is a retrospective observational study of patients receiving intra-articular SI joint injections under a single provider at the Cleveland Clinic from September 2013 to April 2019. Three hundred fifty-one patients received injections and were administered patient reported outcomes (PROs) including the Numeric Rating Scale, Patient Health Questionnaire, Pain Disability Questionnaire, EuroQol-5 Dimensions Questionnaire, and PROMIS-GH Physical and Mental Health at baseline and approximately 1-, 3-, 6-, 12-, and 24-month time points during follow-up appointments. The primary outcome measure was the percentage of patients receiving their first injection who achieved minimal clinically important difference (MCID) in these PROs at each follow-up time point. Secondary outcomes were the percentage of patients achieving MCID in each PRO for each injection analyzed (including patients who received repeat injections) and average change in these PROs at each time point for first and all injections.
A total of 351 patients were included in the analysis, with varying time points of follow-up. The average patient age was 52.3 (±14.9) years with 74.9% female and 59.0% white. For first time injections, the MCID was achieved for Numeric Rating Scale in 60.6%, 42.1%, 47.5%, and 32.5% of patients at 1-, 3-, 6-, and 12-month follow-up, respectively. There was significant improvement in PROMIS-GH Physical Health at 3-month, 6-month, and 1-year follow-up. There was no significant improvement in PROMIS-GH Mental Health at any follow-up time points.
Fluoroscopically guided intra-articular SI joint injection for SI joint dysfunction is effective in providing therapeutic pain relief exceeding MCID values in greater than 60% of patients at 1 month and greater than 40% at 3- and 6- months after injection. However, while this intervention may provide significant pain relief and improvement in function, it may not address the psychosocial aspect of chronic pain to the same extent.
本项目的目标是评估在荧光镜引导下对已确诊骶髂关节功能障碍患者进行关节内骶髂关节注射的治疗效果。评估了患者报告的与疼痛和生活质量指标相关的结果。
这是一项对2013年9月至2019年4月在克利夫兰诊所由单一医生进行关节内骶髂关节注射的患者的回顾性观察研究。351名患者接受了注射，并在基线以及随访预约期间大约1个月、3个月、6个月、12个月和24个月的时间点接受了患者报告结局（PROs）评估，包括数字评分量表、患者健康问卷、疼痛残疾问卷、欧洲五维健康量表以及患者报告结果测量信息系统-一般健康状况的身体和心理健康量表。主要结局指标是在每个随访时间点首次接受注射且在这些PROs中达到最小临床重要差异（MCID）的患者百分比。次要结局是每次分析的注射（包括接受重复注射的患者）中在每个PRO中达到MCID的患者百分比，以及首次注射和所有注射在每个时间点这些PROs的平均变化。
共有351名患者纳入分析，随访时间点各不相同。患者平均年龄为52.3（±14.9）岁，女性占74.9%，白人占59.0%。对于首次注射，在1个月、3个月、6个月和12个月随访时，数字评分量表达到MCID的患者分别为60.6%、42.1%、47.5%和32.5%。在3个月、6个月和1年随访时，患者报告结果测量信息系统-一般健康状况的身体健康有显著改善。在任何随访时间点，患者报告结果测量信息系统-一般健康状况的心理健康均无显著改善。
对于骶髂关节功能障碍，荧光镜引导下的关节内骶髂关节注射在注射后1个月能使超过60%的患者、3个月和6个月时使超过40%的患者获得超过MCID值的治疗性疼痛缓解。然而，虽然这种干预可能提供显著的疼痛缓解和功能改善，但它可能无法在同等程度上解决慢性疼痛的社会心理方面问题。
