천장관절 증후군 환자에서 관절강 내 증식치료의 효과
Effects of Intraarticular Prolotherapy on Sacroiliac Joint Pain
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Background: Sacroiliac (SI) joint pain is a challenging condition that causes lower back or buttock pain; however, there is no universally accepted long-term treatment. There have been several reports of ligament prolotherapy for SI joint pain, but these have had inconsistent results, probably due to the lack of a specific diagnosis for patient selection and variability in the volume, number and sites of injection. Therefore, this study was conducted to assess the efficacy of intraarticular prolotherapy for relieving SI joint pain diagnosed by local anesthetic intraarticular injection. Methods: Twenty-two patients with SI joint pain confirmed by 50% or more improvement in response to local anesthetic block underwent intraarticular prolotherapy with 25% dextrose water every other week three times. The numeric rating scale (NRS) for pain and Oswestry disability index (ODI) were assessed at the initial visit and after completion of a series of prolotherapy and the NRS was checked during monthly follow-up sessions to evaluate the long-term effectiveness of this technique. Results: Twenty patients completed prolotherapy and followed up as scheduled. The NRS and ODI were significantly improved from 6 (4-8) and 34.1 ± 15.5 to 1 (0-3) and 12.6 ± 9.8 (P < 0.01), respectively, at 1 month after prolotherapy. The mean duration of pain relief of 50% or more was 12.2 months (95% CI, 10.0-14.3) as determined by Kaplan-Meier survival analysis. Conclusions: Intraarticular prolotherapy provided long-term relief of sacroiliac joint pain and may have more benefits than ligament prolotherapy or neurolysis.
Abstract
Background: Sacroiliac (SI) joint pain is a challenging condition that causes lower back or buttock pain; however, there is no universally accepted long-term treatment. There have been several reports of ligament prolotherapy for SI joint pain, but these have had inconsistent results, probably due to the lack of a specific diagnosis for patient selection and variability in the volume, number and sites of injection. Therefore, this study was conducted to assess the efficacy of intraarticular prolotherapy for relieving SI joint pain diagnosed by local anesthetic intraarticular injection. Methods: Twenty-two patients with SI joint pain confirmed by 50% or more improvement in response to local anesthetic block underwent intraarticular prolotherapy with 25% dextrose water every other week three times. The numeric rating scale (NRS) for pain and Oswestry disability index (ODI) were assessed at the initial visit and after completion of a series of prolotherapy and the NRS was checked during monthly follow-up sessions to evaluate the long-term effectiveness of this technique. Results: Twenty patients completed prolotherapy and followed up as scheduled. The NRS and ODI were significantly improved from 6 (4-8) and 34.1 ± 15.5 to 1 (0-3) and 12.6 ± 9.8 (P < 0.01), respectively, at 1 month after prolotherapy. The mean duration of pain relief of 50% or more was 12.2 months (95% CI, 10.0-14.3) as determined by Kaplan-Meier survival analysis. Conclusions: Intraarticular prolotherapy provided long-term relief of sacroiliac joint pain and may have more benefits than ligament prolotherapy or neurolysis.
참고문헌 (23)
- Schwarzer AC, "The sacroiliac joint in chronic low back pain", Spine, 20, pp.31~37 (1995)
- Chakraverty R, "Audit of conservative management of chronic low back pain in a secondary care setting--part I: facet joint and sacroiliac joint interventions", Acupunct Med, 22, pp.207~213 (2004)
- Hanly JG, "Efficacy of sacroiliac corticosteroid injections in patients with inflammatory spondyloarthropathy: results of a 6 month controlled study", J Rheumatol, 27, pp.719~722 (2000)
- Cohen SP, "Lateral branch blocks as a treatment for sacroiliac joint pain: a pilot study", Reg Anesth Pain Med, 28, pp.113~119 (2003)
- Yin W, "Sensory stimulation- guided sacroiliac joint radiofrequency neurotomy: technique based on neuroanatomy of the dorsal sacral plexus", Spine, 28, pp.2419~2425 (2003)
- Cohen SP, "Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment", Anesth Analg, 101, pp.1440~1453 (2005)
- Cusi M, "The use of prolotherapy in the sacro-iliac joint", Br J Sports Med (2008)
- Rabago D, "A systematic review of prolotherapy for chronic musculoskeletal pain", Clin J Sport Med, 15, pp.376~380 (2005)
- Yelland MJ, "Prolotherapy injections for chronic low back pain: a systematic review", Spine, 29, pp.2126~2133 (2004)
- Hooper RA, "Case series on chronic whiplash related neck pain treated with intraarticular zygapophysial joint regeneration injection therapy", Pain Physician, 10, pp.313~318 (2007)
- Dreyfuss P, "The value of medical history and physical examination in diagnosing sacroiliac joint pain", Spine, 21, pp.2594~2602 (1996)
- Dussault RG, "Fluoroscopy- guided sacroiliac joint injections", Radiology, 214, pp.273~277 (2000)
- Daitch J, "Modified sacroiliac joint injection technique", Pain Physician, 9, pp.367~368 (2006)
- Hansen HC, "Sacroiliac joint interventions: a systematic review", Pain Physician, 10, pp.165~184 (2007)
- Liu YK, "An in situ study of the influence of a sclerosing solution in rabbit medial collateral ligaments and its junction strength", Connect Tissue Res, 11, pp.95~102 (1983)
- Bowen V, "Macroscopic and microscopic anatomy of the sacroiliac joint from embryonic life until the eighth decade", Spine, 6, pp.620~628 (1981)
- 심재항, "요통 환자에서 천장골관절 내 주사의 효과: 단기적 추적 관찰", The Korean Journal of Pain, 16(2), pp.175~180 (2003), 대한통증학회
- Huntoon MA, "Complications associated with chronic steroid use. In: Complications in regional anesthesia and pain medicine. 1st ed", pp.331~339 (2006), WB Saunders
- Huntoon MA, "Back to the future: the end of the steroid century?", Pain Physician, 11, pp.713~716 (2008)
- Cohen SP, "Randomized placebo-controlled study evaluating lateral branch radiofrequency denervation for sacroiliac joint pain", Anesthesiology, 109, pp.279~288 (2008)
- Cohen SP, "Outcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation", Reg Anesth Pain Med, 34, pp.206~214 (2009)
- Kapural L, "Sacroiliac joint radiofrequency denervation: who benefits?", Reg Anesth Pain Med, 34, pp.185~186 (2009)
- McKenzie-Brown AM, "A systematic review of sacroiliac joint interventions", Pain Physician, 8, pp.115~125 (2005)
