Comparative Effectiveness of Open versus Minimally Invasive Sacroiliac Joint Fusion

Ledonio, Charles Gerald T.; Polly, David W.; Swiontkowski, M.F.; Cummings, John

doi:10.1016/j.spinee.2014.08.140

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Increasing evidence supports the safety and effectiveness of SIJ fusion in patients with chronic SIJ dysfunction, and several device systems are now available. The most commonly studied device – triangular titanium implants (iFuse Implant System, SI-BONE, Santa Clara, CA, USA) – is supported by prospective clinical trials6–8 as well as a pooled analysis of those trials9 and numerous case series 10–18. Herein, we report 4-year prospective follow-up, updating a previously published report of the same cohort at 3 years 19…”

Section: Introductionmentioning

confidence: 69%

Four-year outcomes after minimally invasive transiliac sacroiliac joint fusion with triangular titanium implants

Darr

Cher

2018

MDER

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BackgroundIncreasing long-term evidence supports the safety and effectiveness of minimally invasive sacroiliac joint fusion (SIJF) for sacroiliac joint (SIJ) dysfunction, an important cause of chronic low-back/buttock pain.ObjectiveTo report 4-year follow-up in patients undergoing SIJF using triangular titanium implants (TTI) as part of two prospective trials.MethodsWe enrolled 103 subjects at 12 centers treated with TTI in two prospective clinical trials (NCT01640353 and NCT01681004) and followed them in the current study (NCT02270203), with clinic visits at 3, 4, and 5 years.ResultsAt 4 years, mean SIJ pain scores (available in 91 subjects [88.3%]) had decreased by 54 points from baseline; disability (Oswestry Disability Index) scores decreased by 26 points; and quality of life (EuroQOL-5D) improved by 0.3 points (0–1 scale). Satisfaction rates were high and the proportion of subjects taking opioids decreased from 77% at baseline to 43% at 4-year follow-up.ConclusionFour-year follow-up showed continued excellent responses in patients with SIJ pain treated with SIJF using triangular titanium implants.

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Section: Introductionmentioning

confidence: 69%

Four-year outcomes after minimally invasive transiliac sacroiliac joint fusion with triangular titanium implants

Darr

Cher

2018

MDER

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“…There are several available devices for MI SIJ fusion that are placed laterally. However, the majority of the clinical evidence which supports the safety and effectiveness of the procedure, including multiple randomized controlled clinical trials (RCTs) [ 15 , 16 ], a large prospective multicentre study [ 17 ], multiple comparative cohorts [ 17 – 19 ], and long-term studies, evaluated procedures performed with TTIs. Results from these surgeries indicate that MI SIJ fusion results in a substantial immediate and sustained improvement in pain, disability, and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective

Blissett¹,

Blissett²,

Ede

et al. 2020

PharmacoEconomics Open

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Objective The aim was to identify the cost-effectiveness of minimally invasive sacroiliac joint fusion (MI SIJF) surgery with titanium triangular implants for patients with sacroiliac joint (SIJ) pain who have failed conservative management, compared to non-surgical management (NSM) from a National Health Service (NHS) England perspective. Methods Over a time horizon of 5 years, a cohort state transition model compared the costs and outcomes of treating patients with MI SIJF to those of traditional NSM treatment pathways. The NSM arm included two treatments: grouped physical therapy and corticosteroid injections (PTSI) or radiofrequency ablation (RFA). Three different strategies were considered: (1) a stepped pathway, (2) patients split between PTSI and RFA, and (3) RFA only. The outcome measure was incremental cost-effectiveness ratio (ICER), reported in 2018 British pounds per quality-adjusted life year (QALY) gained. One-way and probabilistic sensitivity analyses were used to test the robustness of the model results. Results Patients undergoing MI SIJF accrued total procedure-related and pain-management costs of £8358, while NSM treatment strategy 1 had total costs of £6880. The MI SIJF cohort had 2.98 QALYs compared to strategy 1 with 2.30 QALYs. This resulted in an ICER for MI SIJF versus strategy 1 of £2164/QALY gained. Strategy 2 of the NSM arm had lower costs than strategy 1 (£6564) and 2.26 QALYs, and this resulted in an ICER of £2468/QALY gained for MI SIJF. Strategy 3 of the NSM arm had lower costs than strategy 1 (£6580), and this resulted in 2.28 QALYs and an ICER of £2518/QALY gained for MI SIJF. Probabilistic sensitivity analysis shows that at a threshold of £20,000/QALY gained, MI SIJF has a probability of being cost-effective versus NSM strategies of 96%, 97%, and 91% for strategies 1, 2, and 3, respectively. Conclusion MI SIJF appears to be cost-effective over a 5-year time horizon when compared to traditional NSM pathways in an NHS context. Electronic supplementary material The online version of this article (10.1007/s41669-020-00236-5) contains supplementary material, which is available to authorized users.

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“…It also allowed for a minimally invasive approach to maximize recovery in an elderly patient. 18 Because this FIG. 5.…”

Section: Lessonsmentioning

confidence: 99%

Robot-assisted revision of sacroiliac joint fusion using a triangular titanium implant in an S2-alar-iliac trajectory: illustrative case

Triano

Fayed

Sandhu

2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Sacroiliac joint (SIJ) dysfunction can lead to significant pain and disability, greatly impairing quality of life. Arthrodesis may take up to 1 year to occur, after which revision can be considered. There is a need for highly accurate and reproducible techniques for revision that allow for purchase through undisturbed bone to prevent prolonged pain and disability. Moreover, a minimally invasive technique for revision would be favorable for recovery, particularly in elderly patients. OBSERVATIONS An 84-year-old man with a prior history of lumbar fusion presented with severe buttock pain limiting ambulation and sitting because of the failure of arthrodesis after SIJ fusion 1 year earlier. He underwent revision using a triangular titanium implant (TTI) in an S2-alar-iliac (S2-AI) trajectory under robotic guidance, which is a novel technique not yet described in the literature. The patient’s pain largely resolved, he was able to ambulate independently, and his quality of life improved tremendously. There were no complications of surgery. LESSONS Placement of a TTI using an S2-AI trajectory is a safe and effective method for revision that can be considered for elderly patients. Robot-assisted navigation can be used to facilitate an accurate and reproducible approach using a minimally invasive approach.

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Comparative Effectiveness of Open versus Minimally Invasive Sacroiliac Joint Fusion

Cited by 3 publications

References 30 publications

Four-year outcomes after minimally invasive transiliac sacroiliac joint fusion with triangular titanium implants

Four-year outcomes after minimally invasive transiliac sacroiliac joint fusion with triangular titanium implants

Minimally Invasive Sacroiliac Joint Fusion with Triangular Titanium Implants: Cost-Utility Analysis from NHS Perspective

Robot-assisted revision of sacroiliac joint fusion using a triangular titanium implant in an S2-alar-iliac trajectory: illustrative case

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