ISASS Policy 2016 Update – Minimally Invasive Sacroiliac Joint Fusion

Lorio, Morgan P.

doi:10.14444/3026

Cited by 16 publications

(9 citation statements)

References 56 publications

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“…However, utilizing a standardized approach to the diagnosis of SIJ pain is helpful and should include the following areas: subjective experience, physical exam, diagnostic tests, and response to diagnostic blocks. 9,10 Following appropriate diagnosis, treatment for SIJ pain starts with conservative measures including physical therapy, medications, and injections, which may then progress to more invasive options, such as radiofrequency ablation, if pain control is not achieved. 11,12 If long-term pain relief is not achieved with initial interventions and treatments, then it is reasonable to consider SIJ fusion.…”

Section: Introductionmentioning

confidence: 99%

Pain Relief Salvage with a Novel Minimally Invasive Posterior Sacroiliac Joint Fusion Device in Patients with Previously Implanted Pain Devices and Therapies

Deer¹,

Rupp²,

Budwany³

et al. 2021

JPR

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Background Sacroiliac joint (SIJ) pain is a common cause of low back pain, a problem experienced by two-thirds of adults in the United States population. Traditionally, the management of persistent SIJ-related pain has involved conservative therapies (physical therapy, topical medications, oral anti-inflammatory medications), interventional therapies (SIJ steroid injections or ablation), and surgery (SIJ fusion; open and lateral approach). Recent advancements in technology have paved the way for SIJ fusion via a posterior approach, which aims to minimize complications and enhance recovery. Objective The purpose of this study is to introduce the concept of the posterior approach to SIJ fusion as a feasible adjunct and salvage technique for patients with inadequate pain relief from other minimally invasive surgical procedures, and to validate its efficacy through a retrospective multicenter data analysis. Design Multicenter retrospective observational study. Methods Patients with refractory SIJ pain were treated by interventional pain physicians at one of the eight different pain management centers. All patients underwent posterior SIJ fusion via the LinQ TM sacroiliac fusion procedure. Demographical data were collected, in addition to patient-reported pain relief. Results A total of 111 patients were included in the study and underwent posterior SIJ fusion for refractory SIJ-related pain following the use of spinal cord stimulation (SCS), interspinous spacer (ISS), intrathecal drug delivery (IDDS), and/or minimally invasive lumbar decompression (MILD). Overall, the mean patient reported pain relief following posterior SIJ fusion was 67.6%. In patients with a history of failed back surgery syndrome, the mean patient reported pain relief was 76.5%. Conclusion In this retrospective case series of patients with continued intolerable pain following SCS, ISS, IDDS, or MILD, a novel posterior SIJ fusion device provided significant pain relief in a salvage manner. These early results suggest that this intervention may be a therapeutic option to consider in these patients.

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Section: Introductionmentioning

confidence: 99%

Pain Relief Salvage with a Novel Minimally Invasive Posterior Sacroiliac Joint Fusion Device in Patients with Previously Implanted Pain Devices and Therapies

Deer¹,

Rupp²,

Budwany³

et al. 2021

JPR

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“…With the advent of minimally invasive SIJF, familiarity and interest in the condition have grown and specialty society guidelines are now available. 35 , 36 Published literature confirming the safety and effectiveness of SIJF is expanding and now includes two prospective multicenter randomized trials, 16 , 17 a prospective multicenter single-arm trial 18 and multiple case series. 19 – 30 …”

Section: Discussionmentioning

confidence: 99%

Long-term prospective outcomes after minimally invasive trans-iliac sacroiliac joint fusion using triangular titanium implants

Darr

Meyer

Whang

et al. 2018

MDER

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BackgroundMinimally invasive sacroiliac joint fusion (SIJF) has become an increasingly accepted surgical option for chronic sacroiliac (SI) joint dysfunction, a prevalent cause of unremitting low back/buttock pain.ObjectiveThe objective of this study was to report clinical and functional outcomes of SIJF using triangular titanium implants (TTI) in the treatment of chronic SI joint dysfunction due to degenerative sacroiliitis or sacroiliac joint (SIJ) disruption at 3 years postoperatively.MethodsA total of 103 subjects with SIJ dysfunction at 12 centers were treated with TTI in two prospective clinical trials (NCT01640353 and NCT01681004) and enrolled in this long-term follow-up study (NCT02270203). Subjects were evaluated in study clinics at study start and again at 3, 4, and 5 years.ResultsMean (SD) preoperative SIJ pain score was 81.5, and mean preoperative Oswestry Disability Index (ODI) was 56.3. At 3 years, mean pain SIJ pain score decreased to 26.2 (a 55-point improvement from baseline, p<0.0001). At 3 years, mean ODI was 28.2 (a 28-point improvement from baseline, p<0.0001). In all, 82% of subjects were very satisfied with the procedure at 3 years. EuroQol-5D (EQ-5D) time trade-off index improved by 0.30 points (p<0.0001). No adverse events definitely related to the study device or procedure were reported; one subject underwent revision surgery at year 3.7. SIJ pain contralateral to the originally treated side occurred in 15 subjects of whom four underwent contralateral SIJF. The proportion of subjects who were employed outside the home full- or part-time at 3 years decreased somewhat from baseline (p=0.1814), and the proportion of subjects who would have the procedure again was lower at 3 years compared to earlier time points.ConclusionIn long-term (3-year) follow-up, minimally invasive trans-iliac SIJF with TTI was associated with improved pain, disability, and quality of life with relatively high satisfaction rates.Level of evidenceLevel II.Clinical relevanceSIJF with TTI.

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“…The sacroiliac joint (SIJ) is a recognized source of low back pain [ 1 , 2 ]. When conservative therapy fails and diagnostic tests, such as provocative maneuvers and SIJ injections, confirm the SIJ is the source of symptoms, a fusion of the symptomatic joint can be an effective treatment [ 3 ]. While clinical outcomes following SIJ fusion (SIJF) are the most commonly reported result in peer-reviewed publications, an SIJF should, by definition, minimize motion between the ilium and the sacrum, based on the clinical hypothesis that motion across the joint is causing symptoms.…”

Section: Introductionmentioning

confidence: 99%

The Assessment of Fusion Following Sacroiliac Joint Fusion Surgery

Abbasi

Hipp²

2017

Cureus

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Sacroiliac joint fusions (SIJF) have been the subject of many research studies. The technical success of an SIJF is in part determined by whether osseous bridging occurs across the sacroiliac joint (SIJ). However, no validated SIJF assessment method has been described. Our objective was to document previously described SIJF assessment methods and define and validate a detailed assessment system for SIJF. Our results are only intended to establish computed tomography (CT)-based guidelines for SIJF to be used in a subsequent large clinical study to correlate them with clinical outcomes.The SIJF literature was reviewed to document previous descriptions of SIJF assessments. A detailed system was then developed for assessing SIJF from CT exams. To provide data that can be used to address a range of research questions, the system included assessing bridging bone relative to the SIJ anatomy, bridging bone immediately adjacent to the threaded implants crossing the joint, as well as bridging bone close to but not immediately adjacent to the implants. The system was applied to assessing SIJF from thin-slice CT exams in 19 patients 12 months following surgery. Two experienced radiologists implemented the assessment system, and in the event of a disagreement, an adjudicator was used.Most prior studies provide very little detail about how SIJF was assessed. Using the new assessment system, the agreement between the primary readers was substantial (0.67 using Gwet’s AC1 statistic). Bridging bone representing a fusion of the SIJ was identified in most patients both immediately adjacent to the threaded implants crossing the joint, as well as distant to the implants.A detailed radiographic assessment system proved to be applicable to SIJF. The assessment system includes explicit language describing the location and extent of bridging bone across the SIJ. Standardization of the assessment of the SIJFs may allow for a more meaningful comparison of data between studies.

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ISASS Policy 2016 Update – Minimally Invasive Sacroiliac Joint Fusion

Cited by 16 publications

References 56 publications

Pain Relief Salvage with a Novel Minimally Invasive Posterior Sacroiliac Joint Fusion Device in Patients with Previously Implanted Pain Devices and Therapies

Pain Relief Salvage with a Novel Minimally Invasive Posterior Sacroiliac Joint Fusion Device in Patients with Previously Implanted Pain Devices and Therapies

Long-term prospective outcomes after minimally invasive trans-iliac sacroiliac joint fusion using triangular titanium implants

The Assessment of Fusion Following Sacroiliac Joint Fusion Surgery

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