Low Back Pain, Mechanical, Lumbar Disc Herniation, Sciatica, Spine Stiffness
Conditions
Keywords
Disc Prolapse, sacroiliac joint, Injection, Ultrasound
Brief summary
Bilateral sacroiliac joint injection in symptomatic lumbar disc prolapse under ultrasound guidance and studying the effect of this technique on pain, spine mobility and activity of daily living.
Detailed description
86 Patients with lumbar disc prolapse diagnosed by either MRI or CT will be included. All of them aged \> 18 years with no special condition for the duration of disc prolapse. All of them had clinical manifestations in the form of mechanical low back pain or sciatica or limited spine mobility. All participants had no or poor response to conservative treatment. Previous surgery, severe facet arthropathy, ankylosing spondylitis, sensory or motor deficit and wedge fracture were considered as exclusion criteria. Distraction, compression, thigh thrust, and sacral thrust were used to assess SIJ dysfunction only at baseline before injection. Fingertip to floor and Oswestry disability index (ODI) were used to assess mobility and function of the spine at baseline (before and after injection) and after 2 and 16 weeks. Visual Analogue Scale (VAS) was used for pain appraisal at the same intervals. Participants will be randomly assigned into active and control group using 1:1 allocation. In the active group bilateral SIJ injection will be performed under ultrasound US guidance. Under US guidance a 22G spinal needle, where 1 mL 2 % lidocaine hydrochloride (xylocaine, AstraZeneca) mixed with triamcinolone 40 milligrams (Kenacort, Bristol Myers Squip) will be injected in each SIJ.
Interventions
PROCEDUREBilateral SIJ injection
under US guidance a 22G spinal needle, where 1 mL 2 % lidocaine hydrochloride (xylocaine, AstraZeneca) mixed with triamcinolone 40 milligrams (Kenacort, Bristol Myers Squip) will be injected in each SIJ
Sponsors
Sohag University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Lumbar disc prolapse diagnosed by either MRI or CT were included. * All of them aged \> 18 years * No special condition for the duration of disc prolapse. * All of them had clinical manifestations in the form of mechanical low back pain or sciatica or limited spine mobility. * All participants had no or poor response to conservative treatment
Exclusion criteria
* Previous surgery * Severe facet arthropathy * Ankylosing spondylitis * Sensory or motor deficit * Wedge fracture
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain assessment by visual analogue scale. | at baseline 0 time, after 2 weeks and after 16 weeks | Visual analogue scale, 0 means no pain and 10 means the maximum possible pain. |
| Spine mobility, finger tip to floor test | Baseline 0 time, after 2 weeks and after 16 weeks | comparison to the intial values with each visit to detect changes with no definite references. |
| Oswestry disability index | Baseline 0 time, after 2 weeks and after 16 weeks | 0 value means no disability and 100 means complete disability |
Countries
Egypt
Outcome results
None listed