Original Article   

Journal of Neurosurgical Sciences 2022 Jun 28

DOI: 10.23736/S0390-5616.22.05581-3

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Comparison between intraarticular and combined intra and periarticular sacroiliac injection: a prospective randomized controlled clinical trial

Mostafa F. TANTAWY ✉, Wael M. NAZIM

Unit of Neurosurgery, Department of Neurosurgery, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt

BACKGROUND: Sacroiliac joint dysfunction is one of the most common causes of low back pain. The aim of our study was to determine whether combined injection (intra and periarticular) of sacroiliac joint provides greater pain relief than only intraarticular injection.
METHODS: This is a randomized controlled trial between two groups. The first group involved thirty patients treated with combined injection (intra and periarticular) of a mixture of methylprednisolone acetate 40 mg and local anesthetic into a symptomatic sacroiliac joint. The second group (30 patients) received the same mixture only intraarticular. Diagnostic block was done for all cases. All patients failed to respond to medical treatment before proceeding to the injection procedure.
RESULTS: Over 6 months of follow-up, there were statistically significant improvements in patients who received combined sacroiliac joint injection according to pain visual analogue scale (VAS) compared with intraarticular group. Comparing both groups, there was significant difference in the 1 month VAS (one month after the procedure) as the P value was 0.010, and in the 6 months VAS (6 months after the procedure) as the P value was 0.007. There was no significant difference in the pre VAS (P value was 0.795) and immediate post VAS (one week after the procedure) as the P value was 0.145. No complications were reported after the procedure.
CONCLUSIONS: Although both groups provide statistically significant pain relief, patients who received combined sacroiliac joint injection have significantly greater clinical improvement as regard to those who received only intraarticular injection.

KEY WORDS: Sacroiliac; Corticosteroids; Intraarticular; Periarticular; VAS; Injection; Fluoroscopy; Block