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. 2018 Jan 17:12:7-16.
doi: 10.2174/1874325001812010007. eCollection 2018.

Minimally Invasive Sacroiliac Joint Fusion: 2-Year Radiographic and Clinical Outcomes with a Principles-Based SIJ Fusion System

William W Cross  1 , Arnold Delbridge  2 , Donald Hales  3 , Louis C Fielding  4
Affiliations

Minimally Invasive Sacroiliac Joint Fusion: 2-Year Radiographic and Clinical Outcomes with a Principles-Based SIJ Fusion System

William W Cross et al. Open Orthop J. .

Abstract

Background: Sacroiliac joint (SIJ) degeneration is a common source of low back pain (LBP). Minimally invasive (MI) SIJ fusion procedures have demonstrated meaningful clinical improvement. A recently developed MI SIJ fusion system incorporates decortication, placement of bone graft and fixation with threaded implants (DC/BG/TF).

Patients and methods: Nineteen patients who had MI SIJ fusion with DC/BG/TF were enrolled at three centers. Fusion was assessed in CT images obtained 12 and 24 months postoperatively by an independent radiographic core laboratory. LBP was assessed using a 0-10 numerical pain scale (NPS) preoperatively and at 12 and 24 months postoperatively.

Results: At 12 months, 15/19 patients (79%) had bridging bone across the SIJ, and at 24 months 17/18 patients (94%) available for follow-up had SIJ fusion. Of the patients with bridging bone 88% had fusion within the decorticated area, with solid fusion in 83%. A significant reduction in NPS scores was demonstrated, representing a 73% reduction in average low back pain.

Conclusion: The patients in this series demonstrated significant improvement in LBP. Fusion rates at 24 months demonstrate promise for this system, which utilizes the established orthopedic principles of DC/BG/TF to achieve arthrodesis. Further study is warranted to demonstrate comparative fusion rates for different implant systems.

Keywords: Bridging bone; Decortication; Fusion; Low back pain; Minimally invasive; Radiographic fusion; Sacroiliac fusion; Sacroiliac joint.

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Figures

Fig. (1)
Fig. (1)
SImmetry System. Panel A illustrates the decorticator instrument preparing the graft bed (arrow); the decorticated region is then packed with approximately 5cc of graft material (B; arrow). Final implant construct (C), showing a 12.5mm cannulated implant (inferior) with surrounding decorticated area and graft (arrow) and 6.5mm anti-rotation implant (superior).
Fig. (2)
Fig. (2)
Radiographic fusion status (error bars represent 95% CI).
Fig. (3)
Fig. (3)
CT images assessed as bridging bone with solid fusion (A), bridging bone with possible fusion (B) and not fused (C).
Fig. (4)
Fig. (4)
Low Back Pain (numerical pain scale, 0-10; error bars represent 95% CI).
Fig. (5)
Fig. (5)
Comparison of current and reported radiographic fusion results for MI SIJ fusion [12-14, 16-18, 31].
See this image and copyright information in PMC

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