Diagnosis and Management of Sacroiliac Joint Dysfunction

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The sacroiliac joint (SIJ) is a source of potentially disabling low back pain1. However, diagnosis and management of SIJ dysfunction is not only challenging but also controversial. A comparison of patients in clinical trials of minimally invasive fusion (MIF) with nationally representative cross-sectional survey data (National Health Measurement Study [NHMS]) revealed that SIJ dysfunction results in a high burden of disease, estimated at 0.5 quality-adjusted life-year (QALY), which is lower than for conditions such as chronic obstructive pulmonary disorder, coronary artery disease, angina, asthma, and mild heart failure, and is comparable with many surgical orthopaedic conditions (hip or knee osteoarthritis, degenerative spondylolisthesis, and spinal stenosis)1. Patients with SIJ dysfunction have been reported to have substantially lower health-related quality of life (HRQoL) scores (Short Form-36 [SF-36] physical component summary [PCS], SF-36 mental component summary [MCS], Short Form-6D [SF-6D], and EuroQol-5D [EQ-5D]) and to reside in lower deciles for utility compared with NHMS controls2.
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