Comparative analysis of fluoroscopic-guided and ultrasound-guided sacroiliac joint injection in patient with clinical sacroComparative analysis of fluoroscopic-guided and ultrasound-guided sacroiliac joint injection in patient with clinical sacroiliitisiliitis

Abstract

Background& Objective Sacroiliac joint (SIJ) arthritis is a common cause of chronic mechanical low back pain (LBP), The complex anatomy of sacroiliac joint (SIJ) mandates an imaging modality to perform the diagnostic or therapeutic joint injection. That is often treated with injection of local anesthetic with or without steroids. Ultrasound (US) has emerged as a viable alternative to fluoroscopy to guide SIJ injections; however, few studies have compared these modalities, we compared both accuracy and efficacy of US and FL guidance for SIJ injections

Materials & Methods: We made randomized prospective study included forty consecutive patients with median to severe chronic low back pain treated with one side sacroiliac joint injection. Patients ages range between 20- 80year old patients with sacroiliitis were randomly allocated into two groups, and were given SIJ injection using either fluoroscopy  or ultrasound  as a guide to intervene., the injection was done in Al Mouwasat University Hospital, Clinical assessments were carried out at a baseline after one week, month, 3-month follow-up visit using the visual analog scale for pain, Oswestry Disability Index for disability-specific measure and Macnab criteria for global effectiveness, and compared through analysis using paired-samples “t” tests

Results: Analysis of Visual Analog Scale one-week post-procedure showed a significant decrease in both groups: 12.5% in Echo group (p = 0.002) and 9.5% in fluoroscopic group (p = 0.006). No significant difference in NRS between two groups at one- and three-months post-procedure (p = 0.11 and 0.1, respectively). Comparison of ODI at three-month post-procedure revealed that both groups had a statistically significant improvement (p < 0.0001). There was no significant difference in Oswestry Disability Index between two groups at three-months post-procedure (p = 0.01)

Conclusion: Ultrasound-guided Sacroiliac joint injection has similar accuracy and efficacy to fluoroscopy guided Sacroiliac joint injection in patients with chronic low back pain secondary to Sacroiliac joint arthritis.