Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?

Abstract

Purpose The purpose of this prospective case series (level II) was to determine the clinical outcomes of anterior SIJ fusion, comparing the outcomes of patients who had prior spinal fusions at any level compared to patients who have not. Methods This prospective study included 25 patients who underwent SIJ fusion with anterior plate fixation. All patients had failed non-operative treatment, had a positive Patrick test, and positive response to intra-articular SIJ injections with greater than 50 % pain relief. Patients had follow-up at 3, 6, 9 and 12 months where they completed Oswestry disability index (ODI) and Short Musculoskeletal Functional Assessment (SMFA) surveys. Outcome data are available for 19 patients who completed pre-operative and 12-month follow-up surveys. Their average time of the final follow-up was 1.1 years (range 10-33 months). Results Significant improvements between pre-operative and the final follow-up in ODI (p = 0.007) and SMFA (p = 0.01) were observed; the ODI assessed outcomes in patients who had previous spinal fusion surgery were significantly worse than those that did not at the final followup (p = 0.04). Conclusion Patients who have not undergone prior spinal fusion surgery, regardless of age, gender, and BMI have better outcomes following anterior SIJ fusion.

Comparative Effectiveness of Open versus Minimally Invasive Sacroiliac Joint Fusion

“…32,33 Similarly, it is not clear if patients with previous spine fusions respond to all sacroiliac joint fusion techniques in a manner similar to that of patients who have isolated sacroiliac joint pain. Poorer outcomes were reported by Slinkard et al 20 who used an open anterior approach and Mason et al 34 using a hollow modular anchorage screw MIS technique, while Rudolf, 26 Cummings and Capobianco, 35 and Sachs and Capobianco 36 reported similar outcomes for both patient groups after using the same triangular implant as that used in the present study.…”

“…The MCID is defined as the smallest change in a treatment outcome that a patient would identify as important and has been used previously in the treatment of lumbar spine disorders. 20 The Fisher's exact test was used to compare categorical measures, such as sex of patient and history of prior lumbar surgery. The Shapiro-Wilk test was applied to check for normal or skewed distributions.…”

One-year outcomes after minimally invasive sacroiliac joint fusion with a series of triangular implants: a multicenter, patient-level analysis

“…A history of sleep disturbance, pain on prolonged sitting, leg instability, and pain in the lower back, buttock, hip, and groin, as well as the SI joint, are common. Furthermore, pain and degeneration of the SI joint after lumbar spinal fusion is common, with up to 43% of these patients experiencing SI joint pain and 75% showing radiographic changes 27,28. An accurate diagnosis requires a combination of history, physical examination maneuvers that stress the SI joint, and image-guided intra-articular diagnostic injections.…”

Open versus minimally invasive sacroiliac joint fusion: a multi-center comparison of perioperative measures and clinical outcomes

“…Several studies report up to 30% prevalence of SI joint disorders in patients diagnosed with low back pain [2,4-6]. Disorders of the SI joint may be the result of trauma, pregnancy, inflammatory arthritis, osteoarthritis or degeneration of the joint either de novo or post lumbar spinal fusion [7]. SI joint pain after lumbar fusion is not uncommon.…”