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Durable intermediate- to long-term outcomes after minimally invasive transiliac sacroiliac joint fusion using triangular titanium implants

Authors Sachs D, Kovalsky D, Redmond A, Limoni R, Meyer SC, Harvey C, Kondrashov D

Received 26 March 2016

Accepted for publication 5 May 2016

Published 13 July 2016 Volume 2016:9 Pages 213—222

DOI https://doi.org/10.2147/MDER.S109276

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Donald Sachs,1 Don Kovalsky,2 Andy Redmond,3 Robert Limoni,4 S Craig Meyer,5 Charles Harvey,6 Dimitriy Kondrashov7

1Center for Spinal Stenosis and Neurologic Care, Lakeland, FL, 2Orthopaedic Center of Southern Illinois, Mount Vernon, IL, 3Precision Spine Care, Tyler, TX, 4BayCare Clinic, Green Bay, WI, 5Columbia Orthopaedic Group, Columbia, MO, 6Riverside Medical Center, Kankakee, IL, 7SF Spine Group at St Mary’s Spine Center, San Francisco, CA, USA

Background: Sacroiliac joint (SIJ) fusion (SIJF), first performed 95 years ago, has become an increasingly accepted surgical option for chronic SIJ dysfunction. Few studies have reported intermediate- or long-term outcomes after SIJF.
Objective: The objective of this study is to determine patient-based outcomes after SIJF for chronic SIJ dysfunction due to degenerative sacroiliitis or SIJ disruption at ≥3 years of follow-up.
Methods: Consecutive patients who underwent SIJF prior to December 2012 were contacted over phone or through email. Participants completed questionnaires in clinic, over phone or by email, regarding SIJ pain, activities related to SIJ dysfunction, and the Oswestry Disability Index. Charts were reviewed to extract baseline parameters and the clinical course of follow-up.
Results: One hundred seven patients were eligible and participated in this study. Mean (standard deviation) preoperative SIJ pain score was 7.5 (1.7). At mean follow-up of 3.7 years, the mean SIJ pain score was 2.6 (representing a 4.8-point improvement from baseline, P<0.0001) and the mean Oswestry Disability Index was 28.2. The ability to perform activities commonly impaired by SIJ dysfunction showed positive improvements in most patients. SIJ revision surgery was uncommon (five patients, 4.7%). Fourteen patients (13.1%) underwent contralateral SIJF during follow-up, 25.2% of patients had additional non-SIJ-related lumbar spine or hip surgeries during follow-up.
Conclusion: In intermediate- to long-term follow-up, minimally invasive transiliac SIJF was associated with improved pain, low disability scores, and improved ability to perform activities of daily living.

Keywords: sacroiliac joint fusion, chronic low back pain, multicenter study

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