A systematic review and update on diagnosis and treatment of new onset sacroiliac joint dysfunction after lumbar fusion

Karimi, Helen; Rodrigues, Rahul; Patel, Shrey; Patel, Jainith; Kosarchuk, Jacob; Kryzanski, James

doi:10.1007/s00701-024-05918-1

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…The SIJ may be implicated as a source of persistent LBP owing to its susceptibility to biomechanical alterations following lumbar spine surgery. The incidence of SIJ dysfunction is estimated to be 7.0% following lumbar fusion surgery and increases with the number of fused segments, peaking in patients with three or more levels of fusion [ 78 ]. Diagnostic injection into the SIJ combined with positive outcomes from SIJ pain provocation tests enhances the probability of the SIJ being identified as a source of pain [ 79 ].…”

Section: Managementmentioning

confidence: 99%

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review

Yeo

2024

JYMS

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Amid the worldwide increase in spinal surgery rates, a significant proportion of patients continue to experience refractory chronic pain, resulting in reduced quality of life and escalated healthcare demands. Failed back surgery syndrome (FBSS) is a clinical condition characterized by persistent or recurrent pain after one or more spinal surgeries. The diverse characteristics and stigmatizing descriptions of FBSS necessitate a reevaluation of its nomenclature to reflect its complexity more accurately. Accurate identification of the cause of FBSS is hampered by the complex nature of the syndrome and limitations of current diagnostic labels. Management requires a multidisciplinary approach that may include pharmacological treatment, physical therapy, psychological support, and interventional procedures, emphasizing realistic goal-setting and patient education. Further research is needed to increase our understanding, improve diagnostic accuracy, and develop more effective management strategies.

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Section: Managementmentioning

confidence: 99%

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review

Yeo

2024

JYMS

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Comparative Efficacy of Quadratus Lumborum Muscle Energy Technique with Gluteus Medius Strengthening Versus Gluteus Medius Strengthening Alone in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial

Soomro,

Karimi,

Gilani

2024

Diagnostics

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Background: Pain in the sacroiliac joint is the most prevalent and often overlooked. The sacroiliac joints are thought to be sources of pain in roughly 10% to 25% of patients with chronic lower back pain. Due to the biomechanical nature of the joint, muscle imbalance is the most important cause of sacroiliac joint dysfunction. The hamstring and gluteus medius are the primary muscles involved in postural dysfunction-related muscle imbalance; however, the quadratus lumborum’s role in the compensatory mechanism is becoming more apparent, and its potential for treatment in conjunction with gluteus medius strengthening has not yet been investigated. Gluteus medius exercises, along with conventional treatment, are routinely given to patients with sacroiliac joint dysfunction; however, the aim of this study is to explore the additional effects of the muscle energy technique (MET) on the quadratus lumborum along with strengthening of the gluteus medius on pain, disability and quality of life of patients with sacroiliac joint dysfunction. Methods: Using a computer-generated random number table, seventy patients with unilateral sacroiliac joint pain were divided equally and randomly into two groups. Prior to initiating treatment, baseline measurements were taken using a hand-held dynamometer, visual analog scale (VAS), Oswestry Disability Index (ODI-U) and short form 36-item survey (SF-36v2) to assess strength, pain, functional disability and quality of life, respectively. Over the course of four weeks, all patients received twelve sessions, and both the pre- and post-intervention outcome measures were documented. Results: After 4 weeks of treatment, both groups showed statistically significant (p < 0.005) mean improvements in muscle strength, pain, disability and quality of life before and after intervention. However, the mean improvements in post-intervention on a dynamometer, VAS, ODI and SF-36 were better in the MET with exercise group (METGME) as compared to the conventional group with exercise (CTGME), with a larger effect size. Conclusions: The muscle energy technique, applied to the quadratus lumborum in combination with gluteus medius strengthening, is more effective clinically and significantly in improving pain, disability and quality of life in comparison to conventional treatment of sacroiliac joints with gluteus medius exercises.

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A systematic review and update on diagnosis and treatment of new onset sacroiliac joint dysfunction after lumbar fusion

Cited by 2 publications

References 40 publications

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review

Comparative Efficacy of Quadratus Lumborum Muscle Energy Technique with Gluteus Medius Strengthening Versus Gluteus Medius Strengthening Alone in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial

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