Diskitis, Osteomyelitis, Spinal Epidural Abscess, Meningitis, and Endocarditis Following Sacroiliac Joint Injection for the Treatment of Low-Back Pain in a Patient on Therapy for Hepatitis C Virus

Nagpal, Geeta; Flaherty, John P.; Benzon, Honorio T.

doi:10.1097/aap.0000000000000608

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…Overall, no major complications were reported in this systematic review, even though the literature largely documented the potential drawbacks of intraarticular steroid and anesthetic injections, with the risk of inducing local chondrolysis and osteoporosis, and, in case of surgery, of increased post-operative pain scores [36][37][38][39]. Local corticosteroids injections can lead also to systemic consequences by causing immunosuppression: infection diseases, Cushing's syndrome, weight gain, fluid retention, mood disturbances, and gastrointestinal upset [28].…”

Section: Discussionmentioning

confidence: 99%

Injective Treatments for Sacroiliac Joint Pain: A Systematic Review and Meta-analysis

Ruffilli,

Cerasoli,

Barile

et al. 2024

JOIO

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Background The most effective injective treatment approach for sacroiliac joint (SIJ) pain remains unclear. Aim of this study was to quantify the safety and effectiveness of the available injective strategies to address SIJ pain. Methods A systematic review and meta-analysis of the literature was conducted on PubMed, Scopus, and Embase databases from inception until January 2023. Inclusion criteria were studies written in English, comparative and non-comparative studies regardless of the minimum follow-up, and case series on SIJ injections. Safety and efficacy of the different injection therapies for the SIJ were quantified. A meta-analysis was conducted on the available data of the documented injective therapies. The “Checklist for Measuring Quality” by Downs and Black was used to assess the risk of bias and the quality of papers. Results The literature search retrieved 43 papers (2431 patients): 16 retrospective case series, 2 retrospective comparative studies, 17 prospective case series, 3 prospective comparative studies, and 5 randomized controlled trials. Of the selected studies, 63% examined the effect of steroid injections, 16% of PRP injections, while 21% reported other heterogeneous treatments. The failure rate was 26% in steroid injections and 14% in PRP injections. The meta-analysis showed a statistically significant reduction in pain with the VAS score for both steroids and PRP: steroids improvement at mid-term 3.4 points (p < 0.05), at long-term 3.0 (p < 0.05), PRP improvement at mid-term 2.2 (p = 0.007), at long-term 2.3 points of the VAS pain scale (p = 0.02). Conclusions Steroids are the most documented injective approach, with studies showing an overall safety and effectiveness. Still, the high number of failures underlined by some studies suggest the need for alternative procedures. Early PRP data showed promise, but the limitations of the current literature do not allow to clearly define the most suitable injective approach, and further studies are needed to identify the best injective treatment for SIJ patients.

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Section: Discussionmentioning

confidence: 99%

Injective Treatments for Sacroiliac Joint Pain: A Systematic Review and Meta-analysis

Ruffilli,

Cerasoli,

Barile

et al. 2024

JOIO

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“…It is estimated that 30-50% of adults are colonized with MRSA though totally asymptomatic, therefore screening programs (e.g., nasal swabs, skin swabs) are crucial to identify patients at higher risk of MRSA invasive infection [6,63]. As most MRSA invasive infections occur in patients without a history of MRSA colonization, besides in patients being colonized with MRSA, prophylaxis for SA should be carefully evaluated in every immunocompromised patient undergoing neurosurgery [64,65]. Time is a critical issue: screening should be performed as close to the operation date as possible, but in time to perform decolonization and/or preoperative prophylaxis.…”

Section: Prevention and Prophylaxismentioning

confidence: 99%

How we deal with Staphylococcus aureus (MSSA, MRSA) central nervous system infections

Antonello¹,

Riccardi²

2022

Front. Biosci. (Schol Ed)

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Among central nervous system (CNS) infections (e.g., meningitis, brain abscess, ventriculitis, transverse myelitis), those caused by Staphylococcus aureus (SA) are particularly challenging both in management and treatment, with poor clinical outcomes and long hospital stay. It has been estimated that SA is responsible for around 1%-7% of meningitis (up to 19% in healthcare-associated meningitis). Recent neurosurgical procedures and immunocompromisation are major risk factors for SA CNS infections. Hand hygiene, surveillance nasal swabs and perioperative prophylaxis are crucial points for effective SA infections prevention. In case of SA-CNS infections, pending microbiological results, anti-methicillin-resistant SA (MRSA) antibiotic, with good CNS penetration, should be included, with prompt de-escalation as soon as MRSA is ruled out. Consultation with an expert in antimicrobial therapy is recommended as well as prompt source control when feasible. In this narrative review, we reviewed current literature to provide practical suggestions on diagnosis, prevention, management, and treatment of SA CNS infections.

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“…More serious reactions are rare . There is a case report of joint infection of the SIJ following intra‐articular injection, as well as a case of spinal epidural abscess, meningitis, and endocarditis in an immunosuppressed patient . Research has shown that radiation exposure is low with fluoroscopically guided injections .…”

Section: Summary Of the Published Literaturementioning

confidence: 99%

“…47,48 There is a case report of joint infection of the SIJ following intraarticular injection, 49 as well as a case of spinal epidural abscess, meningitis, and endocarditis in an immunosuppressed patient. 50 Research has shown that radiation exposure is low with fluoroscopically guided injections. [51][52][53] However, the effects of chronic exposure to fluoroscopy operators over time, at the individual radiation dose exposure rate demonstrated by SIJ studies, have not been reported.…”

Section: Adverse Eventsmentioning

confidence: 99%

Image‐Guided Sacroiliac Joint Injections: an Evidence‐based Review of Best Practices and Clinical Outcomes

Zheng

Schneider

Yang

et al. 2019

PM&R

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Injections into the intraarticular sacroiliac joint (SIJ) are commonly done for both diagnostic and therapeutic reasons. Injection of an anesthetic can aid in the diagnosis of SIJ pain. Corticosteroids can be administered with the goal of providing a therapeutic effect. This article summarizes the literature regarding the diagnostic and therapeutic effects of these injections. It includes a review of the various imaging modalities including fluoroscopy, ultrasound, and computed tomography guidance, as well as a discussion on the prevalence data and other variables that may affect the reported outcomes.

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Diskitis, Osteomyelitis, Spinal Epidural Abscess, Meningitis, and Endocarditis Following Sacroiliac Joint Injection for the Treatment of Low-Back Pain in a Patient on Therapy for Hepatitis C Virus

Cited by 9 publications

References 12 publications

Injective Treatments for Sacroiliac Joint Pain: A Systematic Review and Meta-analysis

Injective Treatments for Sacroiliac Joint Pain: A Systematic Review and Meta-analysis

How we deal with Staphylococcus aureus (MSSA, MRSA) central nervous system infections

Image‐Guided Sacroiliac Joint Injections: an Evidence‐based Review of Best Practices and Clinical Outcomes

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