gms | German Medical Science

Objective: Sacroiliac joint (SIJ) pain is a chronic pain condition affecting older adults with a prevalence of 20% among patients with chronic low back pain. While pain medication, physical therapy, joint blocks and denervation procedures achieve pain relive in most patients some cases fail to improve. We developed a new technique for directly stimulating the SIJ as a last minimal invasive option to treat SIJ pain.

Method: Here we present four patients with severe therapy-refractory pain receiving a SIJ peripheral nerve stimulation. Patient's satisfaction, pain and quality of life were evaluated by means of the International Patient Satisfaction Index (IPSI), Oswestry Disability Index 2.0 (ODI) and Visual Analogue Scale (VAS) using standard questionnaires adapted to a German-speaking population. For stimulation we placed an 8 pole electrode parallel to the SIJ.

Results: In all four cases test stimulation achieved more than 50% pain reduction and a permanent neurostimulator was implanted. Initially all patients reported an important improvement in pain and quality of life even after discontinuing of drastically reducing the intake of analgesics. Two patients reported a steady or progressive improvement. The two other subjects had an excellent improvement after two months of continuous stimulation but reported of an increase in pain and disability at the 6 months checkpoint, but without reaching the preoperative values.

Conclusions: We conclude that SIJ stimulation is a useful therapeutic strategy in the treatment of intractable SIJ pain when denervation procedures fail to produce the desired effect. Further studies on larger patient's collectives and longer follow-up times are required to define the precise target group and the long-term effect of this novel treatment method.