Improvement of Back Pain after Intraoperative Sacroiliac Injection during L5-S1 Fixation: A Randomized Controlled Retrospective Study

Background: Sacroiliac joint (SIJ) pain is a common complication following lumbar spinal fusion. The purpose of this research was to determine how effective intraoperative SIJ injection in preventing low back pain after L5-S1 fixation procedures. Methods: This randomized controlled retrospective study was performed on 70 individuals who underwent L5-S1 fixation and were classified equally into two groups: Group A intraoperative SIJ injection was performed, while Group B did not. Pain incidence, Oswestry Disability Index (ODI) scores, and failed back surgery syndrome (FBSS) rates were assessed preoperatively and at 2 weeks, 1, 3, and 6 months postsurgery. Results: At 6 months, Group A showed significantly lower pain incidence (2.86% vs 17.14%, p=0.027) and ODI scores (31.71±6.26 vs 36.06±8.54, p=0.018) than Group B. The FBSS incidence was significantly lower in Group A (8.57% vs 31.43%, p=0.034). No significant differences in complication rates were observed between groups. Conclusions: Intraoperative SIJ injection during L5-S1 fixation appears to reduce longterm pain incidence, improve functional outcomes, and lower FBSS rates without increasing complications. This technique may offer a promising strategy for preventing SIJ-related pain following lumbar spinal fusion.