An Updated Review of Utilization Patterns of Sacroiliac Joint Interventions in the Fee-for-service (ffs) Medicare Population from 2000 to 2022.

PURPOSE OF THE REVIEW: This updated review evaluates utilization patterns of sacroiliac joint (SIJ) interventions, including SIJ injections, radiofrequency neurolysis, and SIJ fusion, using data from the Centers for Medicare and Medicaid Services (CMS) and Physician Supplier Procedure Summary (PSPS) database. RECENT FINDINGS: Between 2019 and 2022, Medicare data revealed a notable significant decline in SIJ intervention utilization, with a cumulative drop of 28.9% and an annual decrease of 10.7% per 100,000 beneficiaries. This represents a stark contrast to the minimal 0.4% annual decline observed from 2010 to 2019. The most significant reduction occurred from 2019 to 2020 (− 18.7%), coinciding with the onset of the COVID-19 pandemic. Utilization declined slightly from 2020 to 2021 (− 1.1%), then more sharply again from 2021 to 2022 (− 11.5%). These patterns mirror trends seen in similar studies on epidural and facet joint interventions, which often evaluate SIJ procedures in tandem. While the Medicare population increased by 63.3% from 2000 to 2022, SIJ injections rose by 281% overall during the same period, with an annual increase of 6.3%. However, post-COVID-19 (2019–2022), there was a 13.5% overall decrease in SIJ procedures, averaging a 4.7% annual decline. The largest drop occurred in 2020 (− 19.2%), followed by an 8.3% rebound in 2021, and a subsequent 1.2% decline in 2022. These findings highlight shifting trends in interventional pain management, particularly in response to public health and economic disruptions.