A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques

Objective The sacroiliac joint can be a primary source of pain or part of multifactorial syndromes. As there is no single historical, physical examination-based, or radiological feature that definitively establishes a diagnosis of sacroiliac joint pain, diagnostic blocks are regarded as the gold sta...

Full description

Bibliographic Details
Main Authors: Gaurav Chauhan, Prabhdeep Hehar, Vivek Loomba, Aman Upadhyay
Format: Article
Language:English
Published: Korean Spinal Neurosurgery Society 2019-06-01
Series:Neurospine
Subjects:
Online Access:http://www.e-neurospine.org/upload/pdf/ns-1836122-061.pdf
_version_ 1797329857878687744
author Gaurav Chauhan
Prabhdeep Hehar
Vivek Loomba
Aman Upadhyay
author_facet Gaurav Chauhan
Prabhdeep Hehar
Vivek Loomba
Aman Upadhyay
author_sort Gaurav Chauhan
collection DOAJ
description Objective The sacroiliac joint can be a primary source of pain or part of multifactorial syndromes. As there is no single historical, physical examination-based, or radiological feature that definitively establishes a diagnosis of sacroiliac joint pain, diagnostic blocks are regarded as the gold standard. The primary aim of this randomized trial was to compare the posteroanterior approach with the classic oblique approach for sacroiliac joint injection based on an assessment of procedure times and patient-reported pain outcomes in subjects scheduled for fluoroscopically-guided sacroiliac joint injections. Methods Thirty patients were randomized into 2 groups of 15 patients each. The endpoints measured included the total length of procedure time, fluoroscopic time, needling time (length of time the needle was maneuvered), and pre- and postprocedure visual analogue scale pain scores. Results The posteroanterior approach was significantly shorter in terms of procedure time (p=0.03) and needling time (p=0.01) than the oblique approach. Adjusting for body mass index, the mean procedure and needling times were significantly shorter in the posteroanterior group than in the oblique group. Conclusion This study of the posteroanterior approach for fluoroscopic-guided sacroiliac joint injection observed shorter times for fluoroscopy, needling, and the overall procedure than were recorded for the widely prevalent oblique approach. This may translate to lower radiation exposure, lower procedural costs, and enhanced ergonomics of fluoroscopicallyguided sacroiliac joint injections.
first_indexed 2024-03-08T07:12:29Z
format Article
id doaj.art-4a2e22858c4241289f5a2b57ee72d540
institution Directory Open Access Journal
issn 2586-6583
2586-6591
language English
last_indexed 2024-03-08T07:12:29Z
publishDate 2019-06-01
publisher Korean Spinal Neurosurgery Society
record_format Article
series Neurospine
spelling doaj.art-4a2e22858c4241289f5a2b57ee72d5402024-02-03T02:20:44ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912019-06-0116231732410.14245/ns.1836122.061827A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique TechniquesGaurav Chauhan0Prabhdeep Hehar1Vivek Loomba2Aman Upadhyay3 Anesthesiology, Pain management, and Perioperative Medicine, Henry Ford Health System, Detroit, MI, USA Anesthesiology, Pain management, and Perioperative Medicine, Henry Ford Health System, Detroit, MI, USA Anesthesiology, Pain management, and Perioperative Medicine, Henry Ford Health System, Detroit, MI, USA Anesthesiology, Pain management, and Perioperative Medicine, Henry Ford Health System, Detroit, MI, USAObjective The sacroiliac joint can be a primary source of pain or part of multifactorial syndromes. As there is no single historical, physical examination-based, or radiological feature that definitively establishes a diagnosis of sacroiliac joint pain, diagnostic blocks are regarded as the gold standard. The primary aim of this randomized trial was to compare the posteroanterior approach with the classic oblique approach for sacroiliac joint injection based on an assessment of procedure times and patient-reported pain outcomes in subjects scheduled for fluoroscopically-guided sacroiliac joint injections. Methods Thirty patients were randomized into 2 groups of 15 patients each. The endpoints measured included the total length of procedure time, fluoroscopic time, needling time (length of time the needle was maneuvered), and pre- and postprocedure visual analogue scale pain scores. Results The posteroanterior approach was significantly shorter in terms of procedure time (p=0.03) and needling time (p=0.01) than the oblique approach. Adjusting for body mass index, the mean procedure and needling times were significantly shorter in the posteroanterior group than in the oblique group. Conclusion This study of the posteroanterior approach for fluoroscopic-guided sacroiliac joint injection observed shorter times for fluoroscopy, needling, and the overall procedure than were recorded for the widely prevalent oblique approach. This may translate to lower radiation exposure, lower procedural costs, and enhanced ergonomics of fluoroscopicallyguided sacroiliac joint injections.http://www.e-neurospine.org/upload/pdf/ns-1836122-061.pdfSacroiliac joint painSacroiliac joint injectionIntra-articular injectionsFluoroscopyAnteroposterior viewOblique view
spellingShingle Gaurav Chauhan
Prabhdeep Hehar
Vivek Loomba
Aman Upadhyay
A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques
Neurospine
Sacroiliac joint pain
Sacroiliac joint injection
Intra-articular injections
Fluoroscopy
Anteroposterior view
Oblique view
title A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques
title_full A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques
title_fullStr A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques
title_full_unstemmed A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques
title_short A Randomized Controlled Trial of Fluoroscopically-Guided Sacroiliac Joint Injections: A Comparison of the Posteroanterior and Classical Oblique Techniques
title_sort randomized controlled trial of fluoroscopically guided sacroiliac joint injections a comparison of the posteroanterior and classical oblique techniques
topic Sacroiliac joint pain
Sacroiliac joint injection
Intra-articular injections
Fluoroscopy
Anteroposterior view
Oblique view
url http://www.e-neurospine.org/upload/pdf/ns-1836122-061.pdf
work_keys_str_mv AT gauravchauhan arandomizedcontrolledtrialoffluoroscopicallyguidedsacroiliacjointinjectionsacomparisonoftheposteroanteriorandclassicalobliquetechniques
AT prabhdeephehar arandomizedcontrolledtrialoffluoroscopicallyguidedsacroiliacjointinjectionsacomparisonoftheposteroanteriorandclassicalobliquetechniques
AT vivekloomba arandomizedcontrolledtrialoffluoroscopicallyguidedsacroiliacjointinjectionsacomparisonoftheposteroanteriorandclassicalobliquetechniques
AT amanupadhyay arandomizedcontrolledtrialoffluoroscopicallyguidedsacroiliacjointinjectionsacomparisonoftheposteroanteriorandclassicalobliquetechniques
AT gauravchauhan randomizedcontrolledtrialoffluoroscopicallyguidedsacroiliacjointinjectionsacomparisonoftheposteroanteriorandclassicalobliquetechniques
AT prabhdeephehar randomizedcontrolledtrialoffluoroscopicallyguidedsacroiliacjointinjectionsacomparisonoftheposteroanteriorandclassicalobliquetechniques
AT vivekloomba randomizedcontrolledtrialoffluoroscopicallyguidedsacroiliacjointinjectionsacomparisonoftheposteroanteriorandclassicalobliquetechniques
AT amanupadhyay randomizedcontrolledtrialoffluoroscopicallyguidedsacroiliacjointinjectionsacomparisonoftheposteroanteriorandclassicalobliquetechniques