1. 2024;27;E337-E343Evaluation and Treatment of Sacroiliac Joint Pain in Patients with History of Vertebral Compression Fractures: A Retrospective Case Series
   Retrospective Study
   Ibrahim M. Umer, DO, Christopher Gharibo, MD, Sudhir Diwan, MD, and Steve M. Aydin, DO.

BACKGROUND: Vertebral compression fractures (VCFs) can affect the entire spinopelvic complex and cause unpredictable patterns of back pain due to their effects on spinal tensegrity and biomechanical compensation. They can lead to significant morbidity and mortality in the aging population and are difficult to diagnose. We aimed to establish a relationship between VCFs and sacroiliac (SI) joint pain.

OBJECTIVES: Demonstration of SI joint (SIJ) pain relief at up to 6 months after kyphoplasty (KP) in patients with VCFs and diagnosed SI dysfunction.

STUDY DESIGN: Retrospective study.

SETTING: All patients were from a private chronic pain and orthopedics practice in the northeastern United States.

METHODS: Fifty-one patients with VCFs diagnosed through imaging and SIJ dysfunction diagnosed through 2 diagnostic SIJ blocks who had failed conservative management were considered for KP. Numeric Rating Scale (NRS 11) scores were recorded at the baseline, after each SIJ block, and at 4 weeks and then 6 months after KP.

RESULTS: Forty-nine patients underwent KP. At 4 weeks after the procedure, there was an 84% average reduction in NRS scores from the baseline (P < 0.01). At 6 months after the procedure, there was an 80% reduction in NRS scores from the baseline (P < 0.01).

LIMITATIONS: Larger sample sizes and a randomized control trial would be important steps in furthering the relationship between VCFs and SIJ.

CONCLUSION: VCFs can cause a referred pain pattern to the SIJ that is best treated by KP for long-term management.

KEY WORDS: Vertebral compression fracture, sacroiliac joint, vertebral augmentation, kyphoplasty, referred pain, axial pain, spinal tensegrity, lower back pain