Manipulation of the Sacroiliac Joint under General Anesthesia versus Other Conservative Treatment for the Management of Post Labor Backache due to Sacroiliac Subluxation

Abstract

Abstract:A prospective comparative study conducted on 12 patients with post labor backache (after 3 days of vaginal delivery till the end of puerperium) in Al-Basrah General Hospital, during the period from July 2009 till October 2010. The aim of this study is to compare between the results of manipulation of sacroiliac joint under general anesthesia and other conservative treatment for the management of post labor backache due to sacroiliac subluxation. The 12 patients included were those who met the diagnostic criteria for sacroiliac subluxation [pain in the sacral region, a positive Piedallu's sign (asymmetrical movement of the posterior superior iliac spine upon forward flexion), a positive pelvic compression test, and asymmetry of the anterior superior iliac spine] plus confirmatory signs of sacroiliac subluxation (straight leg raise, flexion block, positive Patrick's test, pain at Baer's point). The patients were divided into two groups A and B, 6 patients in each , those in group A were treated by NSAID, special pelvic belt and physiotherapy while those in group B were treated by manipulation of the sacroiliac joint under general anesthesia. In group A, pain was relieved partially in 4 patients (66.7%) and in 2 patients (33.3%) there was no improvement after 12 weeks of treatment. While in group B, pain was relieved totally in 5 patients (83.4%) and partial pain relieve in one (16.6%). In conclusion, manipulation of the sacroiliac joint under general anesthesia is superior to other conservative options for the management of post labor sacroiliac subluxation.