Evidence-based radiology (part 1): Is there sufficient research to support the use of therapeutic injections for the spine and sacroiliac joints?
BACKGROUND
This review article addresses the best evidence currently available for therapeutic injection therapy for conditions targeting the spine and sacroiliac joints. The article is presented by spinal region. Controversies and areas of interest for further studies are identified.


CONCLUSIONS
There is conclusive evidence supporting the effectiveness of the caudal approach for the administration of epidural steroid injections for patients with low back pain from a variety of causes. In general, there is moderate-to-strong evidence supporting the use of transforaminal therapeutic epidural injections for lumbar nerve-root compression and facet injections for joint pain arising from these joints in the cervical, thoracic and lumbar spine, but further subgroup analysis is needed to help predict which specific patients may receive the most benefit from these procedures.


CONCLUSIONS
No randomized controlled trials, meta-analyses or systematic reviews addressing the effectiveness of therapeutic sacroiliac joint injections have been found. For some injections, corticosteroids may not provide better outcomes compared to local anesthetic injections alone.
Peterson
Cynthia
C
Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008 Zürich, Switzerland. cynthia.peterson@balgrist.ch
Hodler
Juerg
J
D001175:Arthrography; D019317:Evidence-Based Medicine; D006801:Humans; D007278:Injections, Spinal / Q000639:trends; D017116:Low Back Pain / Q000188:drug therapy*; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging