A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions: systematic review Full Text
Pain Physician, 05/31/2012
Hansen H et al. – 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.Methods
- A systematic review of therapeutic sacroiliac joint interventions.
- 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.
- 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.
- 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.