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

Donald Sachs, Robyn Capobianco, Daniel Cher, Timothy Holt, Mukund Gundanna, Timothy Graven, A Nick Shamie, John Cummings Jr, Donald Sachs, Robyn Capobianco, Daniel Cher, Timothy Holt, Mukund Gundanna, Timothy Graven, A Nick Shamie, John Cummings Jr

Abstract

Background: Sacroiliac joint (SI) pain is an often-overlooked cause of lower-back pain, due in part to a lack of specific findings on radiographs and a symptom profile similar to other back-related disorders. A minimally invasive surgical (MIS) approach to SI joint fusion using a series of triangular, titanium plasma spray-coated implants has shown favorable outcomes in patients with SI joint pain refractory to conservative care. The aim of this study was to provide a multicenter experience of MIS SI joint fusion using a patient-level analysis.

Patients and methods: We report a patient-level analysis from 144 patients with a mean of 16 months postoperative follow-up. Demographic information, perioperative measures, complications, and clinical outcomes using a visual analog scale for pain were collected prospectively. Random-effects regression models were used to account for intersite variability.

Results: The mean age was 58 years, 71% of patients were female, and 62% had a history of lumbar spinal fusion. Mean (95% confidence interval [CI]) operative time was 73 minutes (25.4-118), blood loss was minimal, and hospital stay was 0.8 days (0.1-1.5). At follow-up, mean (95% CI) visual analog scale pain scores improved by 6.1 points (5.7-6.6). Substantial clinical benefit, defined as a decrease in pain by >2.5 points or a score of 3.5 or less, was achieved in 91.9% of patients (95% CI 83.9%-96.1%), and 96% (95% CI 86.3%-98.8%) of patients indicated they would have the same surgery again.

Conclusion: When conservative measures fail to relieve symptoms resulting from degeneration or disruption of the SI joint, MIS SI joint fusion using a series of triangular, porous, titanium plasma spray-coated implants is a safe and effective treatment option.

Keywords: SI joint fusion; arthrodesis; minimally invasive surgery; previous spine surgery; sacroiliac joint.

Figures

Figure 1
Figure 1
iFuse implants (iFuse Implant System®; SI-BONE, Inc., San Jose, CA, USA).
Figure 2
Figure 2
Anteroposterior view of three implants in position.
Figure 3
Figure 3
Lateral view of three implants in position.

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Source: PubMed

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