title: Technical Note: Treatment of Sacroiliac Joint Pain with Peripheral Nerve Stimulation.
abstract: BACKGROUND
  Sacroiliac joint (SIJ) pain affects older adults with a prevalence of up to 20% among patients with chronic low back pain. While pain medication, joint blocks and denervation procedures achieve pain relief in most patients, some cases fail to improve. Our goal was to determine the effectiveness of SIJ peripheral nerve stimulation in patients with severe conservative therapy-refractory SIJ pain.
  
  
  METHODS
  Here we present 12 patients with severe conservative therapy-refractory pain receiving an SIJ peripheral nerve stimulation. Patient satisfaction, pain, and quality of life were evaluated by means of the International Patient Satisfaction Index (IPSI), visual analog scale (VAS), and Oswestry Disability Index 2.0 (ODI) using standard questionnaires. For stimulation we placed an eight-pole peripheral nerve electrode parallel to the SIJ.
  
  
  RESULTS
  Two weeks postoperatively, our patients reported an average ODI reduction from 57% to 32% and VAS from 9 to 2.1. IPSI was 1.1. After six months, the therapy was rated as effective in seven out of eight patients reporting at that period. The average ODI was low at 34% (p = 0.0006), while the VAS index rose to 3.8 (p < 0.0001) and IPSI to 1.9. Twelve months after stimulation, six out of seven patients considered their treatment a success with an average ODI of 21% (p < 0.0005), VAS 1.7 (p < 0.0001), and IPSI 1.3.
  
  
  CONCLUSIONS
  We conclude that SIJ stimulation is a promising therapeutic strategy in the treatment of intractable SIJ pain. Further studies are required to determine the precise target group and long-term effect of this novel treatment method.
authors.affiliation: Department of Neurosurgery, Klinikum Idar- Oberstein, Idar-Oberstein, Germany.
authors.forename: Marin
authors.initials: M
authors.lastname: Guentchev
authors.affiliation: Department of Neurosurgery, Klinikum Idar- Oberstein, Idar-Oberstein, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Preuss
authors.affiliation: Department of Neurosurgery, Klinikum Idar- Oberstein, Idar-Oberstein, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Rink
authors.affiliation: Department of Neurosurgery, Klinikum Idar- Oberstein, Idar-Oberstein, Germany.
authors.forename: Levente
authors.initials: L
authors.lastname: Peter
authors.affiliation: Department of Radiology, Klinikum Idar- Oberstein, Idar-Oberstein, Germany.
authors.forename: Ernst-Ludwig
authors.initials: EL
authors.lastname: Wocker
authors.affiliation: Department of Neurosurgery, Klinikum Idar- Oberstein, Idar-Oberstein, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Tuettenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000473:pathology / Q000523:psychology / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D010525:Peripheral Nerves / Q000502:physiology*; D011788:Quality of Life / Q000523:psychology; D012446:Sacroiliac Joint / Q000473:pathology*; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome
keywords: Low back pain; neuromodulation; sacral nerve stimulation; sacroiliac joint dysfunction; sacroiliac joint pain