Search Our Scientific Publications & Authors

Eur Spine J 2019 Mar 18. Epub 2019 Mar 18.

Department of Orthopaedic Surgery/Low Back Pain and Sacroiliac Joint Center, JCHO Sendai Hospital, Sendai, Miyagi, Japan.

Purpose: To prospectively calculate the incidence of postoperative sacroiliac joint-related pain (SIJP) and investigate the association between spinopelvic parameters and postoperative SIJP after lumbar spine surgery.

Methods: We prospectively enrolled consecutive patients who underwent lumbar spine surgery. We defined postoperative SIJP as unilateral buttock pain according to fulfillment of the following criteria within 3 months of the surgery: a sacroiliac joint (SIJ) score higher than 4/9 postoperatively; positive response to analgesic periarticular SIJ injection with fluoroscopy; no other complications related to the surgery. Read More

Radiol Med 2019 Mar 13. Epub 2019 Mar 13.

Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Viale Bracci 10, 53100, Siena, Italy.

Object: Active sacroiliitis based on magnetic resonance imaging (MRI) without intravenous (I.V.) contrast material injection is considered sufficient for the diagnosis of spondyloarthritis (SpA), according to the Assessment of SpondyloArthritis International Society (ASAS) criteria. Read More

Mayo Clin Proc 2019 Mar 7. Epub 2019 Mar 7.

Department of Anesthesiology and Department of Neurology, Penn State-Hershey Medical Center, PA.

Objectives: To determine the prevalence of intra- and extra-articular sacroiliac joint (SIJ) pain, which injection is more beneficial, and whether fluoroscopy improves outcomes.

Patients And Methods: This patient- and evaluator-blinded comparative effectiveness study randomized 125 participants with SIJ pain from April 30, 2014, through December 12, 2017, to receive fluoroscopically guided injections into the joint capsule (group 1) or "blind" injections to the point of maximum tenderness using sham radiographs (group 2). The primary outcome was average pain on a 0 to 10 scale 1 month after injection. Read More

A A Pract 2019 Feb 27. Epub 2019 Feb 27.

From the Department of Anesthesiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Sacroiliac joint pain is one of the most common causes of low back pain in pregnant women. We present a case of a 30-year-old G2P1 at 20 weeks gestation presenting with intractable low back pain refractory to conservative management. History and physical examination revealed sacroiliac joint as the pain generator. Read More

Am J Phys Med Rehabil 2019 Feb 26. Epub 2019 Feb 26.

MedStar National Rehabilitation Hospital, Regenerative Orthopedics and Sports Medicine.

Objective: The aim of this study was to assess the accuracy of ultrasound guided needle placement for sacroiliac joint injections.

Design: Institutional Review Board (IRB) approval was gained for a prospective cohort study of fifty patients (N=50). Study patients who were referred for sacroiliac joint injections for sacroiliac joint mediate pain, and met inclusion/exclusion criteria, were enrolled in the study. Read More

Pain Physician 2019 Jan;22(1S):S1-S74

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body's own inherent healing armamentarium in the treatment of patient pathology. This therapy's intention is to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous or allogenic biologics. This field is rising like a Phoenix from the ashes of underperforming conventional therapy midst the hopes and high expectations of patients and medical personnel alike. Read More

Pain Physician 2019 01;22(1):E53-E54

Department of Anesthesiology Harbor UCLA Medical Center Torrance, California.

Reg Anesth Pain Med 2019 Jan 23. Epub 2019 Jan 23.

Parkwood Institute Research, Lawson Health Research Institute, London, Ontario, Canada.

Background And Objectives: Radiofrequency ablation (RFA) is a common treatment modality for chronic axial spine pain. Controversy exists over its effectiveness, and outcomes in a real-world setting have not been evaluated despite increasing use of RFA. This study examined changes in healthcare utilization and opioid use after RFA in Ontario, Canada. Read More

Biomed Res Int 2018 17;2018:8793843. Epub 2018 Dec 17.

Department of Neurosurgery, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid 22110, Jordan.

Background: Spine-related pain is a complex heterogeneous condition. Excessive reliance on radiological imaging might lead to overdiagnosis of incidental asymptomatic spinal changes and unnecessary surgery. Approaches to the clinical management of spine pain should (1) identify pain generators, types, patterns, and mechanisms; (2) confirm clinical suspension with a diagnostic injection; and (3) ensure that treatment is aimed at controlling pain and improving patient function rather than image-based surgical success. Read More

Pain Med 2019 Jan 8. Epub 2019 Jan 8.

Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.

Ghana Med J 2018 Sep;52(3):153-157

Department of Anaesthesia, University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Background: The injection of mixture of plain bupivacaine and triamcinolone acetonide into the sacroiliac joint (SIJ) to relieve chronic low back pain is uncommon in the West African sub-region. The objective of this study was to demonstrate the efficacy or otherwise of fluoroscopic-guided SI joint injection in the management of chronic axial low back pain in Nigeria.

Design: This was a prospective observational interventional study. Read More

Neurospine 2018 Oct 7. Epub 2018 Oct 7.

Anesthesiology, Pain management, and Perioperative Medicine, Henry Ford Health System, Detroit, MI, USA.

Objective: The sacroiliac joint can be a primary source of pain or part of multifactorial syndromes. As there is no single historical, physical examination-based, or radiological feature that definitively establishes a diagnosis of sacroiliac joint pain, diagnostic blocks are regarded as the gold standard. The primary aim of this randomized trial was to compare the posteroanterior approach with the classic oblique approach for sacroiliac joint injection based on an assessment of procedure times and patient-reported pain outcomes in subjects scheduled for fluoroscopically-guided sacroiliac joint injections. Read More

Pain Physician 2018 11;21(6):515-540

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Several cell-based therapies have been proposed in recent years the management of low back pain, including the injection of medicinal signaling cells or mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP). However, there is only emerging clinical evidence to support their use at this time.

Objective: To assess the effectiveness of MSCs or PRP injections in the treatment of low back and lower extremity pain. Read More

J Clin Neurosci 2019 Mar 10;61:315-321. Epub 2018 Nov 10.

Department of Neurosurgery, University of Pennsylvania Hospital, Philadelphia, PA, United States.

Sacroiliac (SI) joint can produce debilitating lower back pain with radiation to groin, buttocks, and lower extremities. SI joint dysfunction poses a clinical challenge to the spine surgeons. Studies entailing surgical arthrodesis utilizing Titanium implants have been reported with reputedly high level of patient satisfaction. Read More

Clin Spine Surg 2018 Oct 30. Epub 2018 Oct 30.

Steadman Philippon Research Institute, Vail, CO.

Background: The currently reported incidence of primary sacroiliac joint (SIj) pathology ranges from 15% to 30%. The differential diagnosis of SIj region pain includes pain generated from the lumbar spine, the SIj, and the hip joint. The origins of SIj dysfunctions are controversial and pain generation from this joint has been questioned. Read More

Int Med Case Rep J 2018 11;11:263-264. Epub 2018 Oct 11.

Department of Anesthesiology, Mayo Clinic Hospital, Phoenix, AZ, USA,

Singultus (hiccups lasting longer than 48 hours) is a described complication following epidural steroid injections, sacroiliac joint injections, and facet joint injections. The underlying etiology is not completely understood, but it is a condition that can be distressing to patients. Our case presentation involves a 62-year-old male presenting for cervical epidural steroid injection. Read More

Pain Physician 2018 09;21(5):489-496

North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, India.

Background: Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it be the diagnosis or the treatment. Diagnostic blocks are the gold standard way to diagnose this condition. Radiofrequency neurotomy of the nerves supplying the sacroiliac joint has shown equivocal results due to anatomical variation. Read More

J Am Acad Orthop Surg 2019 Feb;27(3):85-93

From the Department of Orthopedic Surgery (Dr. Thawrani), Cincinnati VA Medical Center, University of Cincinnati College of Medicine, and the Department of Orthopedic Surgery, University of Cincinnati College of Medicine (Dr. Agabegi and Dr. Asghar), Cincinnati, OH.

The sacroiliac joint (SIJ) is a diarthrodial joint that has been implicated as a pain generator in approximately 10% to 25% of patients with mechanical low back or leg symptoms. Unique anatomic and physiologic characteristics of SIJ make it susceptible to mechanical stress and also create challenges in the diagnosis of SIJ pain. A variety of inciting causes for SIJ pain may exist, ranging from repetitive low-impact activities such as jogging to increased stress after multilevel spine fusion surgery to high-energy trauma such as in motor vehicle accidents. Read More

J Pain Res 2018 28;11:1659-1663. Epub 2018 Aug 28.

Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan,

Background: There are no specific radiological findings for the diagnosis of sacroiliac joint-related pain. A diagnostic scoring system had been developed in 2017. The score comprised the sum of scores of six items. Read More

Clin Rheumatol 2019 Feb 11;38(2):465-475. Epub 2018 Sep 11.

Department of Rheumatology, PLA General Hospital, 28# Fuxing Road, Beijing, China.

In recent years, MRI has been regarded as a major diagnostic tool for spondyloarthritis (SpA), and anti-TNF therapy has been widely confirmed as an effective treatment strategy. This study was designed to investigate the correlation between the secreted protein dickkopf-1 (Dkk-1) and abnormal findings on magnetic resonance imaging (MRI) through a prospective study of 30 cases of SpA. Thirty patients with active SpA were included, all treated with recombinant human tumor necrosis factor (TNF) receptor-antibody fusion protein (YiSaiPu) injection at 50 mg/week for 6 months. Read More

Front Vet Sci 2018 23;5:195. Epub 2018 Aug 23.

Department of Veterinary Science, University of Turin, Grugliasco, Italy.

Despite back-pain being a common cause of poor performance in sport horses, a tailored diagnostic workflow and a consolidated therapeutic approach are currently lacking in equine medicine. The aim of the study was to assess the evolution in the veterinarian approach to diagnose and treat back-pain over a 10 years period. To investigate this topic, two surveys were addressed to equine veterinarians working in practice throughout Europe 10 years apart (2006 and 2016). Read More

Curr Opin Anaesthesiol 2018 Dec;31(6):739-748

Department of Anesthesia and Pain Medicine, University of Toronto, University Health Network-Toronto Western Hospital, Toronto, Ontario, Canada.

Purpose Of Review: The purposes of this review are to summarize the advantages and limitations of ultrasound-guided pain interventions, and to illustrate those interventions with peripheral, axial and musculoskeletal pain procedures.

Recent Findings: With the capability of locating the interfascial plane, ultrasonography has led to the emergence of a series of plane blocks for the thoracoabdominal region in the recent decade.Ultrasonography for musculoskeletal procedures has been of growing interest because of the major advantage of direct visualization and scanning of various soft tissues and real-time spread in the injectate, thereby enhancing precision and efficacy, reducing risk of trauma and avoidance of radiation. Read More

J Neurol Surg Rep 2018 Jul 30;79(3):e70-e74. Epub 2018 Jul 30.

Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, New York, United States.

 Advancements in radiological imaging and diagnostic criteria enable doctors to more accurately identify lumbosacral transitional vertebrae (LSTV) and their association with back and L5 distribution leg pain. It is considered the most common congenital anomaly of the lumbosacral spine with an incidence between 4 and 35%, although many practitioners describe 10 to 12% overall incidence. LSTVs include sacralization of the L5 vertebral body and lumbarization of the S1 segment while demonstrating varying morphology, ranging from broadened transverse processes to complete fusion. Read More

J Am Acad Orthop Surg 2018 Sep;26(17):610-616

From Orthopaedic Institute, Allegheny Health Network, Pittsburgh, PA.

Sacroiliac joint (SIJ)-based pain can be difficult to diagnose definitively through physical examination and conventional radiography. A fluoroscopically guided injection into the SIJ can be both diagnostic and therapeutic. The initial phase of treatment involves nonsurgical modalities such as activity modification, use of a sacroiliac (SI) belt, NSAIDs, and physical therapy. Read More

Pain Physician 2018 07;21(4):E367-E376

Ministry of Health Erzurum Regional Training and Research Hospital, Turkey.

Background: Although sacroiliac joint dysfunction (SIJD) is generally regarded as a source of lumbar pain, its anatomical position and the absence of a diagnostic 'gold standard' lead to difficulties at examination and differential diagnosis. However, since sacroiliac (SI) joint blocks only provide information about pathologies of joint origin and since SIJD developing secondary to pathologies in structures around the joint can be missed. Provocation and palpation tests also need to be used in diagnosis. Read More

Pediatr Clin North Am 2018 08;65(4):675-690

Pediatric Translational Research Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.

Juvenile spondyloarthritis (SpA) is a distinct form of juvenile arthritis characterized by male predominance and adolescent onset. Clinical manifestations include lower extremity and sacroiliac joint arthritis, enthesitis, and subclinical gastrointestinal inflammation. Juvenile SpA is an immune-mediated inflammatory disease long recognized as associated with HLA-B27, which may be related to the microbial environment as suggested by its coexistence with reactive arthritis and psoriasis. Read More

Pain Physician 2018 05;21(3):251-258

Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.

Background: Sacroiliac intraarticular injection using the upper one-third joint technique is recommended for injections that are difficult with the lower one-third joint technique.

Objective: To evaluate the success rate of intraarticular sacroiliac joint (SIJ) injections using the upper and lower one-third joint techniques.

Study Design: Prospective randomized noninferiority study. Read More

Zhonghua Yi Xue Za Zhi 2018 Apr;98(15):1158-1161

Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou 510317, China.

To assess the efficacy of Yisaipu tapering in patients with ankylosing spondylitis (AS). A total of 87 cases of AS patients from Guangdong Second Provincial General Hospital who were treated with Yisaipu and celecoxib were retrospectively analyzed from February 2013 to April 2017.All patients received full dose Yisaipu and celecoxib in the initial 12 weeks. Read More

Arthritis Res Ther 2018 04 17;20(1):73. Epub 2018 Apr 17.

Department of Rheumatology, St Vincent's University Hospital, Dublin, Ireland.

Background: The efficacy of corticosteroids in patients with psoriatic arthritis (PsA) and inflammatory back pain has not been studied to date. In this controlled trial, we aimed to investigate the comparative performance of corticosteroids in patients with active axial-PsA (AxPsA) versus those with active ankylosing spondylitis (AS).

Methods: Patients with AxPsA and AS (naïve to biologic therapies), who not only had clinically active disease, but also had bone marrow oedema on magnetic resonance imaging of the sacroiliac joints, were recruited. Read More

Complement Ther Med 2018 Apr 8;37:64-68. Epub 2018 Feb 8.

Physical Medicine & Rehabilitation Service, Department of Veterans Affairs, Northern California Health Care System, Sacramento, CA, United States.

Objectives: Examine the effectiveness of sacroiliac (SI) joint prolotherapy for SI joint instability, and characterize the patients most likely to benefit from this treatment.

Design: Retrospective cohort study.

Setting: Department of Veterans Affairs outpatient physical medicine clinic. Read More

Curr Pain Headache Rep 2018 Jan 26;22(1). Epub 2018 Jan 26.

Jefferson Pain Center, Thomas Jefferson University Hospital, 834 Chestnut St. T150, Philadelphia, PA, 19107, USA.

Chronic pain is a common medical condition. Patients who suffer uncontrolled chronic pain may require interventions including spinal injections and various nerve blocks. Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. Read More

Pain Physician 2018 01;21(1):61-66

Department of Anesthesiology and Critical Care and Pain Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: The anatomic characteristics of the sacroiliac joint (SIJ) make it difficult to achieve intraarticular injection without radiologic guidance. The classic C-arm guided SIJ intervention technique is difficult. Here we describe a new and simple method for SIJ intraarticular intervention. Read More

Clin Neurol Neurosurg 2018 02 21;165:43-46. Epub 2017 Dec 21.

Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan.

Objective: Pain at or around the posterior superior iliac spine (PSIS) is characteristic of sacroiliac joint (SIJ) -related pain. This pain can be treated by either a peri- or intra-articular injection into the joint, with the former being much easier to perform. We investigated whether peri- or intra-articular injections were more frequently effective in patients with SIJ-related pain, and aimed to create an efficient treatment strategy for SIJ-related pain at or around the PSIS. Read More

World Neurosurg 2018 Feb 2;110:354-358. Epub 2017 Dec 2.

Department of Neurosurgery, Nanoori Incheon Hospital, Incheon, Korea.

Background: The causes of chronic diskogenic back pain have not yet been clearly identified. Neural ingrowth around the annulus is widely considered to be one of the possible cause. However, neuropathy around the annulus has yet to be observed visually. Read More

Med Ultrason 2017 Nov;19(4):457-461

Institute of Anatomy, Charles University in Prague, First Faculty Of Medicine, Prague, Czech Republic.

N/A. Read More

Phys Med Rehabil Clin N Am 2018 02;29(1):171-183

Physical Medicine and Rehabilitation Residency Program, VA Caribbean Healthcare System, 10 Casia Street, San Juan, PR 00921, USA.

Sacroiliac joint (SIJ) pain is an important cause of lower back problems. Multiple SIJ injection techniques have been proposed over the years to help in the diagnosis and treatment of this condition. However, the SIJ innervation is complex and variable, and truly intra-articular injections are sometimes difficult to obtain. Read More

Pain Physician 2017 11;20(7):551-567

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA). Read More

Pain Med 2017 Nov;18(11):2081-2095

Department of Orthopaedics, Stanford University, Redwood City, California, USA.

Objective: To provide an overview of a multisociety effort to formulate appropriate use criteria for image-guided injections and radiofrequency procedures in the diagnosis and treatment of sacroiliac joint and posterior sacroiliac complex pain.

Methods: The Spine Intervention Society convened a multisociety effort to guide physicians and define for payers the appropriate use of image-guided injections and radiofrequency procedures. An evidence panel was established to write systematic reviews, define key terms and assumptions, and develop clinical scenarios to be addressed. Read More

J Med Imaging Radiat Oncol 2018 Jun 25;62(3):313-319. Epub 2017 Oct 25.

Medical Faculty, Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Dusseldorf, Germany.

Introduction: Focal F-Fluoride uptake on blood-pool phase PET represents regional hyperaemia, while it indicates osteoblastic activity on mineralization phase PET. This study investigates the link between regional hyperaemia and osteoblastic activity in inflammatory and chronic lesions of ankylosing spondylitis (AS) of the sacroiliac joints (SIJ) using dual-phase F-Fluoride PET/MRI.

Methods: Thirteen patients (six men, seven women, age: 37 ± 10 years) with active AS prospectively underwent dual-phase F-Fluoride PET/MRI. Read More

Pediatr Radiol 2017 Dec 5;47(13):1817-1824. Epub 2017 Oct 5.

Department of Radiology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA.

Background: Reduced-dose C-arm computed tomography (CT) uses flat-panel detectors to acquire real-time 3-D images in the interventional radiology suite to assist with anatomical localization and procedure planning.

Objective: To describe dose-reduction techniques for C-arm CT at a pediatric institution and to provide guidance for implementation.

Materials And Methods: We conducted a 5-year retrospective study on procedures using an institution-specific reduced-dose protocol: 5 or 8 s Dyna Rotation, 248/396 projection images/acquisition and 0. Read More

Curr Sports Med Rep 2017 Sep/Oct;16(5):336-342

1Medical Corps Uniformed Services University of the Health Sciences, Bethesda, MD; and 2Medical Corps Uniformed Services University of the Health Sciences, Bethesda, MD.

Sacroiliac joint (SIJ) dysfunction is a common cause of low back pain in the athlete, especially in sports with repetitive, asymmetric loading. Complex anatomy and broad pain referral pattern make diagnosis difficult. Identifying three or more positive physical examination maneuvers for the SIJ improves examination sensitivity and specificity. Read More

Pain Physician 2017 07;20(5):437-443

Spine & Pain Institute of New York, New York City, New York; Department of Anesthesiology, New York University Langone Medical Center, New York City, New York.

Background: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures. Read More

Phys Med Rehabil Clin N Am 2017 08 27;28(3):621-646. Epub 2017 May 27.

UT Health San Antonio, 7703 Floyd Curl Drive MC 7838, San Antonio, TX 78229, USA.

Interventional procedures can be applied for diagnostic evaluation and treatment of the patient with pelvic pain, often once more conservative measures have failed to provide relief. This article reviews interventional management strategies for pelvic pain. We review superior and inferior hypogastric plexus blocks, ganglion impar blocks, transversus abdominis plane blocks, ilioinguinal, iliohypogastric and genitofemoral blocks, pudendal nerve blocks, and selective nerve root blocks. Read More

Medicine (Baltimore) 2017 Jun;96(26):e7367

aDepartment of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University bDr Ahn's Spine and Pain Clinic, and Dr Ahn's Spine and Pain Institute, Daegu, Republic of Korea.

We investigated the degree of pain reduction following intra-articular (IA) pulsed radiofrequency (PRF) stimulation of the sacroiliac joint (SIJ) in patients with chronic SIJ pain that had not responded to IA corticosteroid injection. Twenty patients were recruited. Clinical outcomes after applying PRF stimulation of the SIJ were evaluated by a numeric rating scale (NRS) and a 7-point Likert scale. Read More

J Ther Ultrasound 2017 26;5:17. Epub 2017 Jun 26.

Department of Anesthesiology-Critical Care, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 USA.

Background: Dysfunction of the Sacroiliac Joint (SIJ) is one of the key sources of low back pain. For prolonged pain relief, some patients undergo fluoroscopic guided radio-frequency (RF) ablation of SIJ, during which a number of RF probes are inserted to create thermal lesions that disrupt the posterior sacral nerve supply. This procedure is minimally invasive, laborious, time-consuming and costly. Read More

Medicine (Baltimore) 2017 Jun;96(25):e7145

Department of Orthopaedics, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang, Jiangxi, China.

Background: Ankylosing spondylitis (AS) is a chronic immune-mediated disease affecting the sacroiliac joints and the spine, manifesting with new bone formation and osteopenia. Five tumor necrosis factor-alpha (TNF-α) inhibitors (infliximab, etanercept, adalimumab, certolizumab, and golimumab) are available for the treatment of AS, however, the results for the safety of TNF-α inhibitors in the treatment of AS are not consistent.

Methods: In this study, we conducted a meta-analysis to determine the safety of TNF-α inhibitors compared with placebo in reducing pain, swelling, and inflammation of AS patients. Read More

Neurosurg Clin N Am 2017 Jul;28(3):301-312

Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Minneapolis, MN 55454, USA; Department of Neurosurgery, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA. Electronic address:

The sacroiliac joint moves 2.5°. It is innervated with nociceptive fibers. Read More