Minimally Invasive Sacroiliac Joint Arthrodesis: Experience in a Prospective Series with 24 Patients

Abstract

Background: Sacroiliac (SI) joint pain conservative treatments show poor outcomes. Hypothesis: surgical treatment will show better results.

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

“…The improvements in quality of life seen in our study mirror those seen in a prior randomized trial [43]. Our study, combined with the prior randomized trial and 4-and 5-year outcomes from both European [39] and US [45] cohorts, suggest that minimally invasive SIJ fusion can be added to the portfolio of spine surgeries proven safe and effective that European surgeons can offer their patients.…”

“…Our findings both replicate and extend previous studies. In previously published case series [36][37][38][39], systematic reviews [40,41], a prospective multicenter clinical trial [42], and a recently published randomized clinical trial of similar design conducted in the USA [43], similar improvements in SIJ pain, self-rated limitations in activities due to pain (Oswestry Disability Index) and quality of life were observed in participants undergoing SIJF. Our study provides an additional, independent confirmation that the improvements after surgery are clinically important and statistically superior to those seen with continued conservative care.…”

“…Finally, our report includes 6-month data only; the study continues to 24 months of planned follow-up. However, one-year data from other prospective trials of the same device/patient population [42,43], as well as longer-term data from retrospective cohorts [39,45] suggest sustained effectiveness.…”

ISASS Policy 2016 Update – Minimally Invasive Sacroiliac Joint Fusion

“…Minimally invasive fusion of the SIJ has been performed with several types of implants, including triangular, porous, titanium coated implants, 19,[27][28][29][30][31][32][33] hollow modular screws, [34][35][36] titanium cages, 37,38 and allograft dowels 21 ( Table 2). Minimally invasive fusion aims to permanently stabilize the SIJ but avoid the morbidity of the open procedure.…”

“…26 Finally, two published studies report that favorable outcomes achieved at one year are sustained long term (up to 5 years). 30,33 The complication rate for minimally invasive SIJ fusion with triangular titanium implants is low. 50 Revision rates over 4 years (3.5% 47 ) are substantially lower than after lumbar fusion surgery, and revision rates in long-term retrospective 30,33 and prospective studies 19,31 have confirmed this low rate.…”