The sixth study evaluated patients with prior history of lumbar or lumbosacral fusion, pain below L5 in a distribution compatible with SIJ pain and three of six positive provocation tests [ 24 ]. All patients had two injections, one with lidocaine and triamcinolone, and one with bupivacaine and triamcinolone. Positive responses to both injections, with at least 75% relief from pain, were reported in 17 of 52 patients [33% (95% CI: 26–40%)]. Factors predictive of positive responses were unilateral pain, positive responses to four or more provocation maneuvers, and pain different from the preoperative pain.
Forty-three (91%) patients reported pain relief after injections. The level of confidence that the site injected was the source of pain increased in 68 (64%) sites, decreased in 19 (18%) sites, and remained unaltered in 19 (18%) sites (P < .01). The treatment plan was changed from nonsurgical initially to surgical in three (8%) of 36 patients and was changed from surgical to nonsurgical in three (27%) of 11 patients after injections. Of the remaining eight patients, treatment was altered in three (37%) as a result of pain relief after the injections.
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