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Comparative Study
. 2013 Apr;22(4):871-7.
doi: 10.1007/s00586-012-2512-8. Epub 2012 Sep 23.

Pelvic joint fusions in patients with chronic pelvic girdle pain: a 23-year follow-up

Thomas J Kibsgård  1 , Olav Røise, Einar Sudmann, Britt Stuge
Affiliations
Comparative Study

Pelvic joint fusions in patients with chronic pelvic girdle pain: a 23-year follow-up

Thomas J Kibsgård et al. Eur Spine J. 2013 Apr.

Abstract

Purpose: Fusion of the sacroiliac joints (SIJ) has been a treatment option for patients with severe pelvic girdle pain (PGP). The primary aims were to evaluate the long-term outcomes in patients who underwent SIJ fusion and to compare 1-year outcomes with long-term outcomes. The secondary aim was to compare patients who underwent SIJ fusion with a comparable group who did not.

Methods: This study includes fifty patients that underwent SIJ fusion between 1977 and 1998. Function (the Oswestry disability index; ODI), pain intensity (visual analogue scale; VAS) and health-related quality of life (SF-36) were determined according to a patient-reported questionnaire. The questionnaire scores were compared with previously recorded 1-year outcomes and with questionnaire scores from a group of 28 patients who did not undergo SIJ fusion.

Results: The patients who underwent SIJ fusion reported a mean ODI of 33 (95 % CI 24-42) and a mean VAS score of 54 (95 % CI 46-63) 23 years (range 19-34) after surgery. Regarding quality of life, the patients reported reduced physical function, but mental health was not affected in the same manner. The patients with successful 1-year outcomes (48 %) retained significantly improved function and reduced pain levels compared with the subgroup of patients with unsuccessful 1-year outcomes (28 %). The patients who underwent surgery did not differ from the non-surgery group in any outcome at the long-term follow-up.

Conclusions: Patients treated with SIJ fusion had moderate disability and pain 23 years after surgery, and the 1-year outcomes were sustained 23 years after surgery. Although many fused patients reported good outcome, this group did not differ from the comparable non-surgical group.

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Figures

Fig. 1
Fig. 1
Flow chart of the study population
Fig. 2
Fig. 2
Each joint was graded after 1 year as good, fair or poor. For comparison purposes, three different subgroups were created based on this 1-year grading
Fig. 3
Fig. 3
The SF-36 questionnaire includes 8 subscales (0 is worst, 100 is best). PF physical functioning, RP role physical, BP bodily pain, GH general health, V vitality, SF social functioning, RE role emotional and MH mental health. The patients who underwent surgery, the non-surgery comparison group and normative scores from the general Norwegian population are presented
See this image and copyright information in PMC

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