Sacroiliac Joint Fusion: Approaches and Recent Outcomes

Yson, Sharon C.; Sembrano, Jonathan N.; Polly, David W.

doi:10.1002/pmrj.12198

Cited by 20 publications

(18 citation statements)

References 15 publications

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“…159 Reviews Several reviews (narrative, systematic, and metaanalysis) have been published focusing on lateral transiliac MIS SIJF with transfixing devices. [186][187][188][189][190][191][192][193] These reviews support the previously stated conclusions, including that lateral MIS SIJF is beneficial (proven improvements in pain and function) in appropriately selected patients with SIJ pain.…”

Section: Level IV Studiessupporting

confidence: 75%

“…The posterior (dorsal) MIS SIJF procedure is a recognized and well-described distinct surgical procedure. 192,193,215 In the dorsal approach, allograft bone products or devices are placed into the ligamentous portion of the joint via dissection of the multifidus muscle and removal of a portion of the ligaments covering the dorsal, posterior aspect of the joint. A portion of the interosseous SIJ ligament is also typically removed.…”

Section: Posterior (Dorsal) Mis Procedures Procedures Descriptionmentioning

confidence: 99%

“…A portion of the interosseous SIJ ligament is also typically removed. 192,193,215 The posterior (dorsal) MIS SIJF procedure is distinct from lateral transiliac MIS SIJF using transfixing devices (CPT code 27279) in several fundamental ways:…”

Section: Posterior (Dorsal) Mis Procedures Procedures Descriptionmentioning

confidence: 99%

“…Published online. 192 ; Martin -Int J Spine Surg. 2020: Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence.…”

mentioning

confidence: 99%

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International Society for the Advancement of Spine Surgery Policy 2020 Update—Minimally Invasive Surgical Sacroiliac Joint Fusion (for Chronic Sacroiliac Joint Pain): Coverage Indications, Limitations, and Medical Necessity

Lorio

Kube²,

Araghi

2020

Int J Spine Surg

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The index 2014 International Society for the Advancement of Spine Surgery Policy Statement-Minimally Invasive Surgical Sacroiliac Joint Fusion-was generated out of necessity to provide an International Classification of Diseases, Ninth Revision (ICD-9)-based background and emphasize tools to ensure correct diagnosis (Appendix Table A1). A timely ICD-10-based 2016 update provided a granular threshold selection with improved level of evidence and a more robust and relevant database. As procedures and treatment options have evolved, this 2020 update reviews and analyzes the expanding evidence base and provides guidance relating to differences between the lateral and dorsal surgical procedures for minimally invasive surgical sacroiliac joint fusion.

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Section: Level IV Studiessupporting

confidence: 75%

Section: Posterior (Dorsal) Mis Procedures Procedures Descriptionmentioning

confidence: 99%

Section: Posterior (Dorsal) Mis Procedures Procedures Descriptionmentioning

confidence: 99%

“…Published online. 192 ; Martin -Int J Spine Surg. 2020: Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence.…”

mentioning

confidence: 99%

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International Society for the Advancement of Spine Surgery Policy 2020 Update—Minimally Invasive Surgical Sacroiliac Joint Fusion (for Chronic Sacroiliac Joint Pain): Coverage Indications, Limitations, and Medical Necessity

Lorio

Kube²,

Araghi

2020

Int J Spine Surg

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“…SIJ arthrodesis is one treatment option for severe and persistent cases of chronic SIJ pain after substantial conservative therapies fail (5). Either open and minimally invasive techniques of SIJ arthrodesis provide longer lasting pain-relief allowing patients to resume a more active life-style such as the return to work or sports (2,(6)(7)(8). Although surgical treatments may involve several complications such as nerve injury or a surgical site infections, it is often the last resort for patients with chronic SIJ pain.…”

mentioning

confidence: 99%

Subchondral Bone Changes Following Sacroiliac Joint Arthrodesis – A Morpho-mechanical Assessment of Surgical Treatment of the Painful Joint

et al. 2021

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Background: Sacroiliac joint arthrodesis is an ultima ratio treatment option for sacroiliac joint dysfunction. Fusion drastically reduces sacroiliac joint movement providing long-lasting pain-relief associated with tension-relief to the innervated sacroiliac joint structures involved in force closure. Objectives: To display the bone mineralization distribution patterns of the subchondral bone plate in 3 distinct regions (superior, anterior, and inferior) of the sacral and iliac counterparts of the sacroiliac joint pre- and post-sacroiliac joint arthrodesis and compare patterns of sacroiliac joint dysfunction postsacroiliac joint fusion with sacroiliac joint dysfunction pre- arthrodesis patterns and those from healthy controls. Study Design: An observational study. Setting: The research took place at the University of Basel, Switzerland, where the specific image analysis program (Analyze, v7.4, Biomedical Imaging Resources, Mayo Foundation, Rochester, NY, USA) was made available. Methods: Mineralization densitograms of 18 sacroiliac joint dysfunction patients pre- and post-sacroiliac joint arthrodesis (≥ 6, ≥ 12, and ≥ 24 months post-surgery) were obtained using computed tomography osteoabsorptiometry. For each patient, pre- vs. post-surgery statistical comparisons were undertaken, using the Hounsfield unit values derived from the subchondral mineralization of superior, anterior, and inferior regions on the iliac and sacral auricular surfaces. Post-operative values were also compared to those from a healthy control cohort (n = 39). Results: In the pre-operative cohort at all 3 follow-up times, the superior iliac region showed significantly higher Hounsfield unit values than the corresponding sacral region (P < 0.01). Mineralization comparisons were similar for the sacrum and ilium in the anterior and inferior regions at all follow-up points (P > 0.5) with no surgery-related changes. Sacral density increased significantly in the post-operative state; not observed on the ilium. Post-operative sacroiliac joints showed a significantly increased mineralization in the superior sacrum after ≥ 6 months (P < 0.05), not replicated after ≥ 12 nor ≥ 24 months. Further comparison of post-operative scans versus healthy controls revealed significantly increased mineralization in the superior sacral region at (≥) 6, 12, and 24 months (P < 0.01), likely related to bone grafting, and in the anterior and inferior regions in post-operative scans at ≥ 12 and ≥ 24 months follow-up (P < 0.05). Limitations: The given study is limited in sample size. Post-operative computed tomography scans had screws which may have left artifacts or partial volume effects on the surfaces. Healthy controls were different patients to the sacroiliac joint dysfunction and post-operative cohorts. Both cohorts were agematched but this comparison did not take into account potential population differences. Size differences in the regions may have also been an influencing factor of the results as the regions were based on the size and shape of the articular surface. Conclusions: Sacroiliac joint arthrodesis results in an increased morpho-mechanical conformity in the anterior and inferior sacrum and reflects variable morpho-mechanical density patterns compared to the healthy state due to permanent alterations in the kinematics of the posterior pelvis. Key words: Bone mineral density, bone mineralization, computed tomography, Hounsfield units, osteoabsorptiometry, sacroiliac, sacroiliac joint arthrodesis, sacroiliac joint fusion, sacroiliac joint dysfunction, subchondral bone plate

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