Predictors and Treatment Strategy of Sacroiliac Joint Pain after Lumbar-Fixation Surgery

Document Type : Original Articles

Authors

Neurosurgery Department , Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.

Abstract

Abstract
Background: Sacroiliac joint pain is a commonly encountered complication following spine surgery. Therefore, its accurate diagnosis and proper management is mandatory for improving the quality of life following spine surgery.
Aim: We aimed to determine the incidence of SIJ degeneration following lumbar fixation and to identify the risk factors.
Patients and Methods: A prospective study on 40 patients who were subjected to lumbar fixation by transpedicular screws. We included patients undergoing surgical lumbar fixation with no preoperative sacroiliac pain, while those who developed sacroiliac pain preoperatively or after surgeries other than fixation were excluded. All cases were operated upon in Kasr Al-Ainy Hospitals between March 2020 and October 2020. Sacroiliac joint pain was assessed post operatively, estimated odds ratios (ORs) with 95% confidence intervals (95% CIs) and P value < 0.05 were used to evaluate the statistical significance of the associations and correlations between variables. A value less than 0.05 was considered statistically significant.

Results: Sacroiliac joint dysfunction occurred in 25 patients (62.5%). BMI, Sacral fusion and multi-level fixation were regarded as important risk factors that lead to increased incidence of sacroiliac joint dysfunction post operatively (p value =0.034, 0.033 and 046 respectively).
Conclusion: The lumbar fixation surgery disrupts the biomechanics of the lumbar spine increasing the incidence of Sacroiliac joint dysfunction. Conservative treatment is the first management of choice and it is effective in some cases. Sacroiliac joint injection with methylprednisolone and local anesthetics is an important line of treatment that gives excellent temporary relief of pain.

Keywords

Pan Arab Journal of Neurosurgery
Volume 16, Issue 2
December 2021
Pages 48-52

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