PMID- 22622913
OWN - NLM
STAT- MEDLINE
DCOM- 20121004
LR  - 20181201
IS  - 2150-1149 (Electronic)
IS  - 1533-3159 (Linking)
VI  - 15
IP  - 3
DP  - 2012 May-Jun
TI  - A systematic evaluation of the therapeutic effectiveness of sacroiliac joint 
      interventions.
PG  - E247-78
AB  - BACKGROUND: The contribution of the sacroiliac joint to low back and lower 
      extremity pain has been a subject of debate with extensive research. It is 
      generally accepted that approximately 10% to 25% of patients with persistent low 
      back pain may have pain arising from the sacroiliac joints. In spite of this, 
      there are currently no definite conservative, interventional, or surgical 
      management options for managing sacroiliac joint pain. In addition, there 
      continue to be significant variations in the application of various techniques as 
      well as a paucity of literature. STUDY DESIGN: A systematic review of therapeutic 
      sacroiliac joint interventions. OBJECTIVE: To evaluate the accuracy of 
      therapeutic sacroiliac joint interventions. METHODS: The available literature on 
      therapeutic sacroiliac joint interventions in managing chronic low back and lower 
      extremity pain was reviewed. The quality assessment and clinical relevance 
      criteria utilized were the Cochrane Musculoskeletal Review Group criteria for 
      randomized trials of interventional techniques and the criteria developed by the 
      Newcastle-Ottawa Scale for observational studies. The level of evidence was 
      classified as good, fair, or poor based on the quality of evidence developed by 
      the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant 
      literature published from 1966 through December 2011 that was identified through 
      searches of PubMed and EMBASE, and manual searches of the bibliographies of known 
      primary and review articles. OUTCOME MEASURES: The primary outcome measure was 
      pain relief (short-term relief = up to 6 months and long-term > 6 months). 
      Secondary outcome measures were improvement in functional status, psychological 
      status, return to work, and reduction in opioid intake. RESULTS: For this 
      systematic review, 56 studies were considered for inclusion. Of these, 45 studies 
      were excluded and a total of 11 studies met inclusion criteria for methodological 
      quality assessment with 6 randomized trials and 5 non-randomized studies. The 
      evidence for cooled radiofrequency neurotomy in managing sacroiliac joint pain is 
      fair.The evidence for effectiveness of intraarticular steroid injections is 
      poor.The evidence for periarticular injections of local anesthetic and steroid or 
      botulinum toxin is poor. The evidence for effectiveness of conventional 
      radiofrequency neurotomy is poor.The evidence for pulsed radiofrequency is poor. 
      LIMITATIONS: The limitations of this systematic review include a paucity of 
      literature on therapeutic interventions, variations in technique, and variable 
      diagnostic standards for sacroiliac joint pain. CONCLUSIONS: The evidence was 
      fair in favor of cooled radiofrequency neurotomy and poor for short-term and 
      long-term relief from intraarticular steroid injections, periarticular injections 
      with steroids or botulin toxin, pulsed radiofrequency, and conventional 
      radiofrequency neurotomy.
FAU - Hansen, Hans
AU  - Hansen H
AD  - Pain Relief Centers, Conover, NC, USA. hans@hippocrates.org
FAU - Manchikanti, Laxmaiah
AU  - Manchikanti L
FAU - Simopoulos, Thomas T
AU  - Simopoulos TT
FAU - Christo, Paul J
AU  - Christo PJ
FAU - Gupta, Sanjeeva
AU  - Gupta S
FAU - Smith, Howard S
AU  - Smith HS
FAU - Hameed, Haroon
AU  - Hameed H
FAU - Cohen, Steven P
AU  - Cohen SP
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Pain Physician
JT  - Pain physician
JID - 100954394
RN  - 0 (Anesthetics, Local)
RN  - 0 (Steroids)
SB  - IM
CIN - Pain Physician. 2012 Nov-Dec;15(6):E1008-10; author reply E1010. PMID: 23159973
MH  - Anesthetics, Local/*therapeutic use
MH  - Humans
MH  - Low Back Pain/*drug therapy
MH  - Pain Measurement
MH  - Sacroiliac Joint/*physiopathology
MH  - Steroids/administration & dosage/*therapeutic use
MH  - Treatment Outcome
EDAT- 2012/05/25 06:00
MHDA- 2012/10/05 06:00
CRDT- 2012/05/25 06:00
PHST- 2012/05/25 06:00 [entrez]
PHST- 2012/05/25 06:00 [pubmed]
PHST- 2012/10/05 06:00 [medline]
PST - ppublish
SO  - Pain Physician. 2012 May-Jun;15(3):E247-78.