Sacral Nerve Stimulation for the Treatment of Sacroiliac Joint Dysfunction: A Case Report

Introduction: Sacroiliac joint (SIJ) dysfunction is a significant contributing factor in 10-30% of individuals with lower back pain. However, definitive diagnostic methods and treatments are still controversial. Methods: We present a case of a 41-year-old woman with left buttock pain, referred pain to the left leg, and dyspareunia. Her visual analogue scale (VAS) pain score was 9/10. Although we performed intramuscular injection into piriformis muscle, intra-articular injection into SIJ, and radiofrequency denervation for the treatment of SIJ pain, her pain repeatedly improved and was reaggravated. Sacral nerve stimulation to the left first sacral foramen via the retrograde cephalocaudal approach was performed. Results: Her VAS pain score decreased to 2-3/10 following sacral nerve stimulation to the left first sacral foramen via the retrograde cephalocaudal approach. Before undergoing sacral nerve stimulation, she had taken anti-depressants, anti-anxietics, analgesics, and anti-convulsants. After the procedure, she required intermittent analgesics only. Conclusions: Sacral nerve stimulation with a percutaneous retrograde cephalocaudal approach is considered to be a useful therapeutic option in the treatment of intractable SIJ dysfunction.