CT-guided stabilization for chronic sacroiliac pain: a preliminary report

We evaluated a percutaneous, computed tomographic, stabilization from S1 to S2, for chronic painful sacroiliac disease. Our hypothesis was that this technique carries low morbidity, and may provide substantial relief of recalcitrant sacroiliac pain.

17 patients had CT guided injection with local anesthesia and steroid to confirm the diagnosis. If symptoms recurred, they had a CT guided stabilization using only local anesthesia and conscious sedation. Outcome was evaluated with a visual analog scale. Univariate analysis and Spearman correlations used for analysis.

Pain improved from a mean of 8.3 pre-injection to 3.5 post-injection and remained at 3.3 at final follow up. Four patients had complete relief, 11 patients had significant pain relief, and two patients experienced little to no pain relief. There was a statistically significant difference between pre-injection and post injection pain scores (p < 0.0001), final and pre injection pain scores (p < 0.0001), but not between the post injection and final pain scores (p = 0.8906). A statistically significant correlation (p < 0.02) was found between final pain score and the difference between pre and post injection scores. There were no infections, hardware or technical complications.

This technique appeared effective in relieving the majority of confirmed sacroiliac pain and appeared to be lasting with few complications. While we did not confirm nor deny an arthrodesis with this technique, it appears that stabilization of the sacroiliac joint may have resulted in enough stability (e.g. alkalosis, mechanical restriction) that it relieved symptoms.