Implant procedure helps people with a common form of back pain

A minimally invasive implant procedure seems to be highly effective at reducing pain and disability for people with back pain that is due to sacroiliac joint dysfunction, reports a trial in Neurosurgery.

Sacroiliac joint dysfunction is improper movement of the joints at the bottom of the spine that can result in pain in the lower back and legs, or inflammation of the joints known as sacroiliitis.
A total of 148 people with low back pain caused by sacroiliac joint dysfunction and had severe pain were investigated. The average pain duration was longer than six years, and about two-thirds of people had been taking opioid (narcotic) medication. Many had previously had non-surgical treatments and spinal surgery.

The volunteers were split into groups. Two-thirds had a minimally invasive sacroiliac joint dysfunction infusion, in which titanium implants were placed through a small incision to stabilise and fuse the sacroiliac joint dysfunction.

The rest of the volunteers received nonsurgical treatments, such as physiotherapy, steroid injections and/or radiofrequency ablation of sacral nerve root lateral branches.

After six months, those in the nonsurgical group had the option to have the implant.

Results
• In terms of pain reduction and absence of complications at six months, the implant procedure was rated successful in 81% of people who had the implant procedure, compared to 26% of people who had no surgery;
• 73% of people in the implant procedure had reduced disability scores, compared to 14% in the nonsurgical group;
• After one year, those who had the implant procedure still had significant reductions in pain and disability, and improved quality of life;
• 35 people in the nonsurgical group then had the implant procedure, with similarly good results.

The minimally invasive implant approach evaluated in this trial has been cleared by the US Food and Drug Administration but this is the first randomised controlled trial to directly compare the results of surgical and nonsurgical treatment for sacroiliac joint dysfunction.

Next steps
The research group is planning CT scans of the volunteers and two years, and a cost-effectiveness comparison.

Click here to read the original research.

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