Computed tomography versus fluoroscopic guided-sacroiliac joint injection: a prospective comparative study

Area of Science:

• Pain Management
• Interventional Radiology
• Musculoskeletal Imaging

Background:

• Limited data exist on long-term outcomes and comparative effectiveness of image-guided sacroiliac joint (SIJ) injections.
• This study addresses the need for comparative analysis of CT and fluoroscopic guidance for SIJ injections.

Purpose of the Study:

• To compare CT-guided versus fluoroscopic-guided SIJ injections.
• To evaluate differences in pain reduction, radiation dose, and patient satisfaction.
• To determine the long-term efficacy of each guidance method.

Main Methods:

• A prospective study involving 52 patients with SIJ pain.
• Injections administered using a standardized mixture of methylprednisolone acetate and lidocaine.
• Assessment of Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) at multiple time points up to 12 months post-procedure.

Main Results:

• Both CT and fluoroscopic guidance significantly reduced NRS scores at one month.
• Significant differences in NRS were observed between groups at six and 12 months, favoring CT guidance.
• Both methods showed significant ODI improvement at six months, with CT guidance demonstrating a statistically significant advantage.

Conclusions:

• CT-guided SIJ injections offer statistically and clinically significant long-term pain relief, comparing favorably to fluoroscopic guidance.
• The implementation of dose reduction protocols in CT imaging is crucial for minimizing radiation exposure.
• CT guidance is a recommended approach for effective SIJ pain management.