Purpose of Review

Prevalence of chronic low back pain (cLBP) is increasing. Sacroiliac joint (SIJ) is a common source of cLBP, but data behind its diagnosis and treatment is controversial. There is moderate quality evidence for effectiveness of therapeutic SIJ injections. However, there are no studies comparing the two most common steroid preparations, methylprednisolone (MTP) and triamcinolone (TAC) in SIJ injections.

Recent Findings

After institutional IRB approval, a retrospective chart review was conducted to evaluate the effectiveness of SIJ injections in terms of pain relief at 1-month follow-up and compare MTP versus TAC. All injections were performed by a single pain physician with fluoroscopic guidance.

Results

Sixty-five percent of patients in the MTP group and 57% patients in the TAC group had >50% pain relief at 1-month follow-up, with no statistical difference between the two groups. Patients in the TAC group had significantly greater BMI and consisted of higher proportion of smokers (72% patients in TAC group versus 39% patients in the MTP group, p-value 0.004). Other sources of pain such as facet joints were unmasked post-procedurally after SIJ injections, with this unmasking being significant for the TAC group. Opiate use decreased in the MTP group from 35% pre-procedurally to 20% post-procedurally, and this difference did not reach statistical significance.

Summary

Both MTP and TAC are effective in providing pain relief for SIJ pain at 1-month follow-up, with no statistical difference between the two types of steroids. Although not statistically significant, there is a modest reduction in opiate use in the MTP group.

中文翻译：

---

骶髂关节注射治疗慢性腰痛的类固醇药物的选择：一项回顾性研究

审查目的

慢性腰痛 (cLBP) 的患病率正在增加。骶髂关节 (SIJ) 是 cLBP 的常见来源，但其诊断和治疗背后的数据存在争议。有中等质量证据证明治疗性 SIJ 注射的有效性。然而，没有研究比较两种最常见的类固醇制剂，甲基强的松龙 (MTP) 和曲安西龙 (TAC) 在 SIJ 注射中。

最近的发现

在机构 IRB 批准后，进行了回顾性图表审查，以评估 SIJ 注射在 1 个月随访时缓解疼痛的有效性，并比较 MTP 与 TAC。所有注射均由一名疼痛医师在透视指导下进行。

结果

MTP 组 65% 的患者和 TAC 组 57% 的患者在 1 个月的随访中疼痛缓解 >50%，两组之间没有统计学差异。TAC 组患者的 BMI 显着更高，吸烟者比例更高（TAC 组患者为 72%，MTP 组患者为 39%，p值 0.004）。在 SIJ 注射后，其他疼痛来源（如小关节）在手术后暴露，这种暴露对 TAC 组很重要。MTP 组的阿片类药物使用从术前的 35% 减少到术后的 20%，这种差异没有达到统计学意义。

概括

MTP 和 TAC 在 1 个月的随访中均能有效缓解 SIJ 疼痛，两种类固醇之间没有统计学差异。尽管没有统计学意义，但 MTP 组中阿片类药物的使用略有减少。