Sacroiliac joint pain: what treatment and when.

IF 3.4 2区 医学 Q2 CLINICAL NEUROLOGY
Federico Cocconi,Nicola Maffulli,Andreas Bell,Michael Kurt Memminger,Francesco Simeone,Filippo Migliorini
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Abstract

INTRODUCTION Spinal and non-spinal pathologies can cause low back pain. Non-spinal sources of low back pain include the sacroiliac joint (SIJ) and the hip. SIJ pain can be treated either conservatively or surgically. Current strategies for managing sacroiliac joint pain are debated, and limited evidence exists. AREAS COVERED The present expert opinion updates current evidence on conservative and surgical modalities for SIJ pain. EXPERT OPINION Surgical management for SIJ pain is effective. However, it exposes patients to surgery and, therefore, related complications. Conservative management may be implemented in patients with moderate SIJ pain, with less than six months of symptoms, or not eligible for surgery. Several noninvasive modalities are available, mostly centered on intra-articular injections. Corticosteroids, platelet-rich plasma, and stem cells have only midterm lasting effects, at most for nine months. Radiofrequency ablation is another methodology for pain relief. Both continuous and pulsatile radiofrequency ablation are associated with good outcomes. SIJ fusion can be performed using different techniques; however, a clear recommendation on the most appropriate modality for the management of SIJ pain is still debated.
骶髂关节疼痛:何时治疗?
简介 脊柱和非脊柱病变均可导致腰背痛。腰背痛的非脊椎病源包括骶髂关节(SIJ)和髋关节。骶髂关节疼痛可通过保守或手术治疗。目前治疗骶髂关节疼痛的策略还存在争议,证据也很有限。本专家意见更新了目前治疗骶髂关节疼痛的保守和手术方式的证据。专家观点手术治疗 SIJ 疼痛是有效的,但患者需要接受手术治疗,因此会出现相关并发症。对于中度 SIJ 疼痛、症状持续时间少于六个月或不符合手术条件的患者,可采取保守治疗。目前有几种非侵入性治疗方法,主要以关节内注射为主。皮质类固醇、富血小板血浆和干细胞只有中期持续效果,最多只能维持九个月。射频消融是另一种缓解疼痛的方法。持续性和脉冲性射频消融术都有良好的疗效。SIJ融合术可采用不同的技术,但关于治疗SIJ疼痛的最合适方法的明确建议仍存在争议。
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来源期刊
Expert Review of Neurotherapeutics
Expert Review of Neurotherapeutics Medicine-Neurology (clinical)
CiteScore
7.00
自引率
2.30%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points
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