Management of sacroiliac joint pain: current concepts

被引:0
作者
Migliorini, Filippo [1 ,2 ,8 ]
Lucenti, Ludovico [3 ]
Bardazzi, Tommaso [2 ]
Bell, Andreas [4 ]
Cocconi, Federico [2 ]
Maffulli, Nicola [5 ,6 ,7 ]
机构
[1] Univ Hosp Halle, Dept Trauma & Reconstruct Surg, Halle, Germany
[2] Acad Hosp Bolzano, Dept Orthopaed & Trauma Surg, Bolzano, Italy
[3] Univ Palermo, Dept Precis Med Med Surg & Cit Care Me Pre CC, Palermo, Italy
[4] Eifelklin St Brigida, Dept Trauma & Orthopaed Surg, Simmerath, Germany
[5] Sapienza Univ Rome, Fac Med & Psychol, Rome, Italy
[6] Queen Mary Univ London, Ctr Sports & Exercise Med, Barts & London Sch Med & Dent, Mile End Hosp, London, England
[7] Keele Univ, Fac Med, Sch Pharm & Bioengn, Stoke On Trent, England
[8] Univ Rome, Dept Life Sci Hlth & Hlth Profess, Link Campus, Rome, Italy
关键词
Sacroiliac; Sacroiliitis; Pain; Management; LOW-BACK-PAIN; INTRAARTICULAR STEROID INJECTION; TRIANGULAR TITANIUM IMPLANTS; RANDOMIZED CONTROLLED-TRIAL; RADIOFREQUENCY ABLATION; COOLED RADIOFREQUENCY; CONSERVATIVE MANAGEMENT; PULSED RADIOFREQUENCY; SYSTEMATIC EVALUATION; DIAGNOSTIC-ACCURACY;
D O I
10.1007/s00590-025-04308-2
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
IntroductionManaging sacroiliac joint (SIJ) pain is challenging and unpredictable. There are no internationally accepted recommendations. In light of the lack of global consensus and guidelines and the ongoing advancements in management options, a widely accepted treatment algorithm remains absent. This systematic review updates and evaluates the existing evidence on strategies for managing SIJ pain.MethodsThis study followed the guidelines defined in the 2020 PRISMA statement. All clinical studies concerning the clinical management of SIJ pain were considered. Web of Science, PubMed, and Embase were accessed in January 2025 without additional filters or temporal constraints. The risk of bias evaluation and statistical analysis followed the guidelines described in the Cochrane Handbook for Systematic Reviews of Interventions.ResultsFifteen randomised controlled trials, 13 clinical trials, and 10 retrospective studies were included. Data from 2666 patients (1429 women) were retrieved. The mean length of follow-up was 14.7 +/- 15.2 months. The mean age was 54.0 +/- 5.8 years, and the mean BMI was 28.5 +/- 2.5 kg/m2. Non-surgical options primarily focus on physical therapy to relieve discomfort. Different medications aim to decrease inflammation and pain at the SIJ. Fluoroscopically guided SIJ injections allow for directly administering steroids or mesenchymal stem cells into the joint. Radiofrequency denervation is frequently used to address SIJ pain, while surgical fusion is usually reserved for cases where conservative treatment is ineffective.ConclusionManaging SIJ pain is challenging due to limited and inconsistent evidence. Treatment progresses from conservative options, physiotherapy, lifestyle changes, and non-steroidal anti-inflammatory drugs to more invasive approaches like injections, radiofrequency denervation, and, in severe cases, surgical management. Research limitations include small sample sizes, short follow-ups, and inconsistent methodologies. Future high-quality studies are needed to establish clear diagnostic and treatment guidelines, compare techniques, and explore new therapies like regenerative medicine.
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页数:12
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