Diagnosis And Treatment Of Sacroiliac Joint Pain After Lumbar Fusion

【Objective】To discuss the clinical characteristics of Sacroiliac joint pain after lumbar fusion as well as its surgical procedure and clinical outcome.【Design】Retrospective,observational study.【Setting】Clinical center in a teaching hospital.【Patients】A total of 34 cases with prior operation for lumbar canal stenosis or lumbar disc herniation or lumbar degenerative spodylolisthesis between June 2003 and December 2006 were reviewed retrospectively.The prior surgical procedure performed was laminectomy,posterolateral fusion or posterior lumbar interbody fusion and pedicle screw fixation.After an avarage of 30.6 months(12-48 months) following the prior surgery,all cases had a recurrence of low back pain.【Method】We used sacroiliac anesthetic blocks to determine this frequency.The diagnostic criterion was a relief of more than 75%of the pain on a visual analog scale.【Results】We found a 26.5%rate of positive blocks.The pain different from the preoperative pain in its distribution and the fusion including L5-S1 had significant value (p=0.017 and p=0.033,respectively).The sex,age,method of the fusion and a free interval of more than 3 months had no significant value(p=1.000,p=1.000,p=0.644 and p=0.591, respectively).【Conclusion】Sacroiliac join pain alter lumbar fusion is one of the causes for recurrence of low back pain which should be distinguished with other causes.For those with marked pain,sacroiliac anesthetic blocks will guarantee good clinical outcome.