gms | German Medical Science

Objective: Sacroiliac joint (SIJ) pain affects older adults with a prevalence of up to 36% among patients with chronic low back pain. While pain medication, joint blocks and denervation procedures achieve pain relief in most patients, some cases fail to improve. Recently we were able to show that peripheral nerve stimulation has a 85.7% success rate in patients with severe conservative therapy-refractory SIJ pain after one year of treatment. In this study we investigated the effect of this novel treatment method for a period of up to 36 months.

Method: Here we present 12 consecutive patients with severe conservative therapy-refractory pain receiving a SIJ peripheral nerve stimulation. Follow-up was at least 36 months in 6 patients, at least 24 months in nine patients and at least 12 months in 12 patients. Patient satisfaction, pain and quality of life were evaluated by means of the International Patient Satisfaction Index (IPSI), Visual Analog Scale (VAS) and Oswestry Disability Index 2.0 (ODI) using standard questionnaires. For stimulation we placed an 8 pole peripheral nerve electrode parallel to the SIJ.

Results: One year postoperatively our patients reported an average VAS reduction from 8,8 to 1.6 (t-test, p<0.0001, as compared to the preoperative data). In 11 out of 12 patients (91.6%) the therapy was rated as effective (IPSI score of 1 or 2). After 24 months the average the VAS score was 2.1 (p<0.0001). In 8 out of 9 patients (88,9%) the therapy was rated as effective. Thirty-six months after stimulation 5 out of 6 patients (83.3%) considered their treatment a success with an average VAS 2.5 (p<0.005).

Conclusions: Our current data show that peripheral nerve stimulation is an effective long-term treatment for therapy-refractory SIJ pain. The consistently high response rate and long follow-up time suggest that this result is unlikely that this is due to a placebo effect.