Comparative Efficacy of Fluoroscopy-guided Sacroiliac Joint Block versus Conservative Management in Sacroiliitis: A Prospective Cohort Study

Abstract

Introduction: Dysfunction of the sacroiliac joint is a frequently overlooked etiology for lumbosacral and gluteal pain. This study compares the efficacy of fluoroscopy-guided sacroiliac joint (SIJ) blocks versus conservative management in patients with sacroiliitis.

Materials and methods: A prospective cohort study was done involving 88 patients diagnosed with sacroiliitis. Group I (n = 48) received conservative management, while Group II (n = 40) underwent fluoroscopy-guided SIJ blocks. Outcomes were assessed using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire at baseline and 6 months.

Results: Significant progress was observed in both groups, but Group II demonstrated superior outcomes. The mean VAS reduction was greater in Group II (5.3 points) compared to Group I (3.1 points). Similarly, functional improvement measured by ODI was higher in Group II (55%) than Group I (39.9%). The EQ-5D-5L index value increased more substantially in Group II (0.42-0.79) than in Group I (0.41-0.67), with statistically significant differences between groups (P = 4.51 × 10-⁸).

Conclusion: Fluoroscopy-guided SIJ blocks provide significantly better pain relief, functional improvement, and life quality enhancement as compared to conservative management in patients diagnosed with sacroiliitis. This intervention should be considered for patients with inadequate response to conservative treatment.

Keywords: Sacroiliitis; fluoroscopy; physiotherapy; sacroiliac joint block.

Figure 1

Fluoroscopic images demonstrating (a) needle placement within the sacroiliac joint (red arrow) and (b) contrast dye diffusion (orange arrows), confirming accurate needle positioning.