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Fundamental Concepts in the Diagnosis of Low Back Pain
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
Now, the examiner asks the patient to roll over into the prone position. The examiner can assess the hip extensor strength, sacroiliac joint, and tender zygopophyseal joints. The examiner can locate the sacroiliac joint by starting at the superior aspect of the gluteal crease and palpating at an angle up to the point where the superior articular process contacts the inferior articular process of the fifth lumbar vertebrae. A provocative test that can be performed to reproduce pain from the sacroiliac joint is the Yeoman’s test. This is performed by flexing the leg and grasping the ankle with both hands and lifting the leg and thigh, which puts maximal stress on the joint. Palpate the facet joints that lie on either side of the spinous processes.
High frequency of lumbar fusion in patients denied surgical treatment of the sacroiliac joint
Published in British Journal of Neurosurgery, 2019
Vicente Vanaclocha-Vanaclocha, Juan Manuel Herrera, Nieves Sáiz-Sapena, Marlon Rivera-Paz, Francisco Verdú-López
Between January 2007 and September 2017, >475 adult patients were evaluated in our neurosurgical department for chronic low back pain.10 We diagnosed probable SIJ pain using the following criteria: 3 or more months of pain in the lumbosacral area immediately medial and below the posterior superior iliac spine with possible radiation into the buttocks, posterior thigh or groin (minimum pain score of 5 on the 0-10 visual analogue scale [VAS]) with no focal neurological signs, an Oswestry Disability Index (ODI) score of at least 30%, a positive Fortin finger test11 and positive findings on at least 3 of 5 physical examination manoeuvres that stress the SIJ (FABER test, Patrick’s test, thigh thrust, distraction test, compression test, Gaenslen test, sacral thrust and Yeoman test). Having 3 or more positive physical examination findings has high predictive power for a positive SIJ block, a reference standard for the diagnosis of SIJ pain.12
Six Month Interim Outcomes from SECURE: A Single arm, Multicenter, Prospective, Clinical Study on a Novel Minimally Invasive Posterior Sacroiliac Fusion Device
Published in Expert Review of Medical Devices, 2022
Aaron K. Calodney, Nomen Azeem, Patrick Buchanan, Ioannis Skaribas, Ajay Antony, Christopher Kim, George Girardi, Chau Vu, Christopher Bovinet, Rainer S. Vogel, Sean Li, Naveep Jassal, Youssef Josephson, Timothy R. Lubenow, Nicholas Girardi, Jason E. Pope
Patients between the ages of 21 to 70 years of age with low back pain for greater than 6 months despite conservative care were considered for the study if they had three of four physical exam maneuvers to diagnose sacroiliitis (FABER test, Gaenslen test, Stork/Gillet Test, and Yeoman’s Test). Once diagnosed as having sacroiliitis, patients with an Oswestry Disability Index (ODI) of at least 30% and a VAS of at least 50 mm for low back/buttock were selected. These patients each underwent a local anesthetic only SIJ injection. If patients received an NRS improvement of at least 50% within 30 to 60 min of injection, they were eligible for the study.