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Sacroiliac joint pain following vertebral augmentation for osteoporotic vertebral compression fractures 2009

Interventional Spine

A. Orlando Ortiz, MD, MBA,
Ritu Bordia, MD, Non ASSR Member
Asante Dickson, MD, Non ASSR Member

Scientific Paper

Mentor Award: No

Institution where work was conducted

Winthro-Universty Hospital

Affiliation and Department

Radiology

Address

120 Mineola Boulevard
Suite 650
Mineola, New York
11501
Phone: 5166632123
Email: oortiz@winthrop.org

Purpose

To assess for a possible correlation between vertebral augmentation in patients being treated for painful osteoporotic vertebral compression fractures and subsequent sacroiliac joint pain

Methods & Materials

A consecutive series of 36 patients undergoing CT guided sacroiliac joint steroid injections over a 2 year period had their medical records reviewed for the occurrence of prior vertebral augmentation, orthopedic surgery or trauma. All patients presented with a clinical diagnosis of sacroiliac joint pain. The side of injection, whether unilateral or bilateral, was recorded. In those patients who had undergone prior vertebral augmentation, the level(s) of the treated vertebrae and the interval between the sacroiliac joint injection and prior vertebral augmentation was recorded in months.

Results

28 of the 36 patients were female and 8 were male with an average age of 75 years. 17 patients underwent unilateral sacroiliac joint injection and 19 patients had bilateral joint injections. 22 out of these 36 patients had undergone prior vertebral augmentation involving T12 and/or one or more lumbar vertebrae. The average time interval between vertebral augmentation and sacroiliac joint injection was 3.4 months with a range of 1 to 8 months. 14 of the 19 patients who received bilateral sacroiliac joint injections also had prior vertebral augmentation. All but one patient had pain provocation and all patients experienced symptomatic relief following their joint injection.

Conclusion

Patients who undergo vertebral augmentation for osteoporotic vertebral compression fractures of the thoracolumbar junction or lumbar spine can present with bilateral sacroiliac joint pain as early as 1 month following their procedure. Patients with recurrent low back pain following vertebral augmentation should undergo physical examination for sacroiliac joint pain as a possible source of their back pain. Furthermore, these patients should not be classified as having had an unsuccessful vertebral augmentation procedure. The sacroiliac joint pain has a high likelihood of responding to image guided steroid injection.

References

AO Ortiz
Medtronic Spine Speakers Bureau
SpineWave Corp Consultant