Advanced surgical and therapeutic trends in the treatment of chronic sacroiliitis in neurosurgery

Abstract

Abstract. The sacroiliac joints are among the largest joints in the human body. They are subjected to heavy loads on a daily basis. The pathology of the sacroiliac joints can be easily missed due to the many common and overlapping symptoms with other diseases in this area. The thin joint capsule, the high mechanical load, and the asymmetrical movement of the pelvic girdle explain the frequent involvement of the sacroiliac joint. Chronic degenerative processes in the joint may result from rheumatic, infectious, drug-dependent and oncological causes. Diseases such as ankylosing spondylitis, psoriatic arthropathy, Bechet’s disease, hyperparathyroidism and various pyogenic causes also cause changes in the joint. Hormonal changes during pregnancy and being overweight are predisposing factors for the development of chronic sacroiliac arthritis. According to the literature, 10-25% of the pain in the area is due to sacroiliac joint pain. Due to the often irradiating pain in different directions, a correct diagnosis is difficult. The therapy of chronic sacroilitis is continuously improving due to the high social importance of this disease. Twenty-eight patients were treated in the Department of Neurosurgery of Pulmed University Hospital with hyaluronic acid injection and corticosteroid blockade, under X-ray control in both sacroiliac joints. Preoperatively, the patients were evaluated using neurological examination and the Oswestry Disability Index, VAS, and “Facial Pain Rating Scale” scales. The results after the minimally invasive methodology showed an excellent response to the pain syndrome. Follow-up of the patients continued up to nine months after the manipulation.