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. 2020 Feb 10;14(Suppl 1):20-29.
doi: 10.14444/6072. eCollection 2020 Feb.

Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence

Christopher T Martin  1 , Lucas Haase  2 , Paul A Lender  1 , David W Polly  1
Affiliations

Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence

Christopher T Martin et al. Int J Spine Surg. .

Abstract

Background: Fusion of the sacroiliac (SI) joint as a treatment for low back pain remains controversial. The purpose of this manuscript is to review the current literature and clinical outcomes of SI joint fusion surgery.

Methods: We conducted a literature review and included studies with the term "sacroiliac joint fusion" that had at least 12 months of clinical follow-up, reported on minimally invasive techniques, and included patient-reported outcome measures.

Results: Two approach types (dorsal and lateral) and numerous different implant manufacturers were identified. Most studies included level 4 data, with a small number of level 2 prospective cohort studies and 2 prospective level 1 studies. Every reviewed study reported clinical benefit in terms of improved pain scores or improvement in validated disability measures. Complication rates were low.

Conclusions: Minimally invasive SI joint fusion provides clinically significant improvement in pain scores and disability in most patients, across multiple studies and implant manufacturers.

Level of evidence: 5.

Clinical relevance: Emerging evidence in support of SI joint fusion indicates that clinicians should examine the SI joint and include SI joint pain in their differential diagnosis for low back pain patients.

Keywords: SI fusion; back pain; biomechanics; evidence; outcomes; review; sacroiliac joint fusion.

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Conflict of interest statement

Disclosures and COI: Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted work. This paper is exempt from institutional review board review because it is not human subjects research. There was no external source of funding for this study.

Figures

Figure 1
Figure 1
Forest plot showing preoperative and postoperative visual analog scale scores. The postoperative time point is 12 months unless otherwise noted for studies that did not provide 12-month data.
Figure 2
Figure 2
Forest plot showing preoperative and postoperative Oswestry Disability Index scores. The postoperative time point is 12 months unless otherwise noted for studies that did not provide 12-month data.
Figure 3
Figure 3
Pooled analysis of weighted means for preoperative and postoperative visual analog scale and Oswestry Disability Index scores. The postoperative time point is 12 months, unless, as previously noted in Figures 1 and 2, the studies did not provide 12-month data.
See this image and copyright information in PMC

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