Does Level of Response to SI Joint Block Predict Response to SI Joint Fusion?

2016 ◽  
Vol 16 (10) ◽  
pp. S288-S289
Author(s):  
David W. Polly ◽  
Daniel J. Cher ◽  
Peter G. Whang ◽  
Clay J. Frank ◽  
Jonathan N. Sembrano
Keyword(s):  
Joint Fusion ◽  
Si Joint

Health Care Economics of SI Joint Fusion

2019 ◽  
Vol 34 (2) ◽  
pp. 103-108
Author(s):  
Daniel Cher ◽  
W. Carlton Reckling
Keyword(s):  
Health Care ◽  
Health Care Economics ◽  
Joint Fusion ◽  
Si Joint

scholarly journals Biplanar x-ray fluoroscopy for sacroiliac joint fusion

2016 ◽  
Vol 41 (videosuppl1) ◽  
pp. 1 ◽  
Author(s):  
Vicente Vanaclocha-Vanaclocha ◽  
Francisco Verdú-López ◽  
Nieves Sáiz-Sapena ◽  
Juan Manuel Herrera ◽  
Marlon Rivera-Paz
Keyword(s):  
Chronic Pain ◽  
Conservative Management ◽  
Sacroiliac Joint ◽  
Da Vinci ◽  
Lateral Projection ◽  
X Ray ◽  
Joint Fusion ◽  
Sacroiliac Joint Fusion ◽  
Si Joint ◽  
Biplanar Fluoroscopy

Chronic pain originating from the sacroiliac joint (SI) can cause severe dysfunction. Although many patients respond to conservative management with NSAIDs, some do need further treatment in the form of SI joint fusion (SIJF). To achieve safe and successful SIJF, intraoperative x-ray fluoroscopy is mandatory to avoid serious damages to nearby vascular and neural structures. Each step of the procedure has to be confirmed by anteroposterior (AP) and lateral projections. With a single-arm x-ray, the arch has to be moved back and forth for the AP and lateral projections, and this lengthens the procedure. To achieve the same results in less time, the authors introduced simultaneous biplanar fluoroscopy with 2 x-ray arches. After the patient is positioned prone with the legs spread apart in the so-called Da Vinci position, one x-ray arch for the lateral projection is placed at a right angle to the patient, and a second x-ray machine is placed with its arch between the legs of the patient. This allows simultaneous AP and lateral x-ray projections and, in the authors' hands, markedly speeds up the procedure. Biplanar fluoroscopy allows excellent AP and lateral projections to be made quickly at any time during the surgical procedure. This is particularly useful in cases of bilateral SI joint fusion if both sides are done at the same time.The video can be found here: https://youtu.be/TX5gz8c765M.

scholarly journals Sacroiliac Joint Fusion Methodology - Minimally Invasive Compared to Screw-Type Surgeries: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 1 (22;1) ◽  
pp. 29-40
Author(s):  
Zung Vu Tran
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Physical Function ◽  
Sacroiliac Joint ◽  
Meta Analysis ◽  
Pain Disability ◽  
Joint Fusion ◽  
Meta Analyses ◽  
Sacroiliac Joint Fusion ◽  
Si Joint

Background: Sacroiliac (SI) joint fusion represents a unique area of orthopedic surgery with procedural literature dating to the early 1920s, showing limited innovation in either technique or hardware over the last 90 years. Recent improvements in the diagnosis and treatment of SI joint dysfunction warrant comparisons to older surgical techniques. Objective: To evaluate treatment efficacies and patient outcomes associated with minimally invasive joint fusion in comparison to screw-type surgeries. Study Design: Systematic review and meta-analysis. Setting: Electronic databases, EMBASE, Pubmed (Medline), manual bibliography cross-referencing for published works until Dec. 31, 2017. Methods: A thorough literature search was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Data repositories accessed included Pubmed and EMBASE, until Dec. 31, 2017. All studies evaluating sacroiliac joint fusion and reporting quantifiable outcome data were included. Exclusion criteria included nonhuman studies, qualitative reviews, and meta-analyses. Data compilation, coding, and extraction were performed using MedAware Systems proprietary software. Data from each study were extracted by 2 analysts, using software that allowed automatic comparisons of all data fields. The standardized mean difference (SMD) was used as a summary statistic for pooling outcomes data across studies. Multiple outcome measures were grouped into 3 categories, according to similarity of measurements - Pain, Disability/Physical Function, and Global/QOL. Results: A total of 20 studies had adequate data to calculate a SMD, and were included in the meta-analysis. Results of iFuse trials were compared to screw type trials, pooled in 3 categories of outcomes - Pain, Disability/Physical Function, and Global/QOL. The Pain category showed a statistically significant (P = 0.03) difference in outcomes for patients receiving the iFuse implant compared to screw types (SMD = 2.04 [95%CI: 1.76 to 2.33] vs. 1.28 [95%CI: 0.47 to 2.09]), with iFuse showing significantly better outcomes. The Disability category also showed a statistically significant (P = 0.01) difference in outcomes for patients receiving the iFuse implant compared to screw types (SMD = 1.68 [95%CI: 1.43 to 1.94] vs. 0.26 [95%CI: -1.90 to 2.41]), with iFuse showing significantly better outcomes. For Global/Quality of Life (QOL) outcomes, there was a significant difference (P = 0.04) between iFuse and screw-type procedures (SMD = 0.99 [95%CI: 0.75 to 1.24] vs. 0.60 [95%CI: 0.33 to 0.88]), with iFuse showing significantly better outcomes. There was a statistically significant correlation between lower baseline Oswestry Disability Index (ODI) and Short Form 36 Health Survey (SF-36) values and better post treatment outcomes (r2 = 0.47, P < 0.01, and r2 = 0.30, P < 0.01, respectively). An association was found between pain at baseline and better outcomes (r2 = 0.21, P < 0.01), where worse baseline pain was associated with better outcomes. Limitations: There was a limited number of studies in this meta-analysis with treatments that could be properly classified as screw-type. Conclusion: In this analysis, compared to screw-type surgeries, the iFuse system showed statistically superior outcomes. This was the case when outcome measures were classified into 3 main categories - Pain, Disability/Physical Function, and Global/QOL. Key words: Meta-analysis, systematic review, sacroiliac joint, sacroiliac joint fusion

scholarly journals Does Level of Response to SI Joint Block Predict Response to SI Joint Fusion?

10.14444/3004 ◽  
2016 ◽  
Vol 10 ◽  
pp. 4 ◽  
Author(s):  
David Polly ◽  
Daniel Cher ◽  
Peter G. Whang ◽  
Clay Frank ◽  
Jonathan Sembrano ◽  
...  
Keyword(s):  
Joint Fusion ◽  
Si Joint

scholarly journals Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

2016 ◽  
Vol 26 (3) ◽  
pp. 708-719 ◽  
Author(s):  
Bengt Sturesson ◽  
Djaya Kools ◽  
Robert Pflugmacher ◽  
Alessandro Gasbarrini ◽  
Domenico Prestamburgo ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Minimally Invasive ◽  
Conservative Management ◽  
Controlled Trial ◽  
Titanium Implants ◽  
Randomized Controlled ◽  
Joint Fusion ◽  
Si Joint

scholarly journals Does Level of Response to SI Joint Block Predict Response to SI Joint Fusion?

2016 ◽  
Vol 6 (1_suppl) ◽  
pp. s-0036-1582758-s-0036-1582758
Author(s):  
David W. Polly ◽  
Daniel Cher ◽  
Peter Whang ◽  
Clay Frank ◽  
Harry Lockstadt ◽  
...  
Keyword(s):  
Joint Fusion ◽  
Si Joint

scholarly journals Sacroiliac Joint Arthrodesis-MIS Technique with Titanium Implants: Report of the First 50 Patients and Outcomes

2012 ◽  
Vol 6 (1) ◽  
pp. 495-502 ◽  
Author(s):  
Leonard Rudolf
Keyword(s):  
Sacroiliac Joint ◽  
Titanium Implants ◽  
Point Change ◽  
Joint Fusion ◽  
Sacroiliac Joint Disruption ◽  
Clinically Significant ◽  
Spine Surgeon ◽  
Sacroiliac Joint Fusion ◽  
Si Joint

This retrospective study of 50 consecutive patients treated by a single orthopedic spine surgeon in private practice was conducted to evaluate the safety and efficacy of minimally invasive sacroiliac joint fusion using a series of triangular, porous plasma spray coated titanium implants.Medical charts were reviewed for perioperative metrics, complications, pain, quality of life and satisfaction with surgery. All patients were contacted at a 24 months post-op to assess SI joint pain, satisfaction with surgery and work status.An early and sustained statistically significant improvement in pain function was identified at all post-operative time points (ANOVA, p<0.000). A clinically significant improvement (>2 point change from baseline) was observed in 7 out of 9 domains of daily living. The complication rate was low and more than 80% of patients would have the same surgery again.MIS SI joint fusion appears to be a safe and effective procedure for the treatment of sacroiliac joint disruption or degenerative sacroiliitis.

scholarly journals Comparative analysis of the lateral and posterolateral trajectories for fixation of the sacroiliac joint—a cadaveric study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Christopher Payne ◽  
Stephen Jaffee ◽  
Isaac Swink ◽  
Daniel Cook ◽  
Matthew Yeager ◽  
...  
Keyword(s):  
Bone Density ◽  
Minimally Invasive ◽  
Cortical Bone ◽  
Volume Fraction ◽  
Bone Volume ◽  
Pull Out ◽  
Joint Fusion ◽  
Joint Gap ◽  
Cortical Density ◽  
Si Joint

Abstract Background A number of minimally invasive sacroiliac (SI) joint fusion solutions for placing implants exist, with reduced post-operative pain and improved outcomes compared to open procedures. The objective of this study was to compare two MIS SI joint fusion approaches that place implants directly across the joint by comparing the ilium and sacrum bone characteristics and SI joint separation along the implant trajectories. Methods Nine cadaveric specimens (n = 9) were CT scanned and the left and right ilium and sacrum were segmented. The bone density, bone volume fraction, and SI joint gap distance were calculated along lateral and posterolateral trajectories and compared using analysis of variance between the two orientations. Results Iliac bone density, indicated by the mean Hounsfield Unit, was significantly greater for each lateral trajectory compared to posterolateral. The volume of cortical bone in the ilium was greater for the middle lateral trajectory compared to all others and for the top and bottom lateral trajectories compared to both posterolateral trajectories. Cortical density was greater in the ilium for all lateral trajectories compared to posterolateral. The bone fraction was significantly greater in all lateral trajectories compared to posterolateral in the ilium. No differences in cortical volume, cortical density, or cancellous density were found between trajectories in the sacrum. The ilium was significantly greater in density compared with the sacrum when compared irrespective of trajectory (p < 0.001). The posterolateral trajectories had a significantly larger SI joint gap than the lateral trajectories (p < 0.001). Conclusion Use of the lateral approach for minimally invasive SI fusion allows the implant to interact with bone across a significantly smaller joint space. This interaction with increased cortical bone volume and density may afford better fixation with a lower risk of pull-out or implant loosening when compared to the posterolateral approach.

scholarly journals The Safety Profile of Percutaneous Minimally Invasive Sacroiliac Joint Fusion

2019 ◽  
Vol 9 (8) ◽  
pp. 874-880 ◽  
Author(s):  
Alan Gregory Shamrock ◽  
Anand Patel ◽  
Milad Alam ◽  
Keith Hayden Shamrock ◽  
Motasem Al Maaieh
Keyword(s):  
Minimally Invasive ◽  
Meta Analysis ◽  
Common Adverse Event ◽  
Complication Rates ◽  
Safe Procedure ◽  
Joint Fusion ◽  
Pain Ratings ◽  
Patient Optimization ◽  
Sacroiliac Joint Fusion ◽  
Si Joint

Study Design: Literature review. Objectives: Systematic review of the existing literature to determine the safety of minimally invasive (MI) sacroiliac (SI) joint fusion through the determination of the rate of procedural and device-related intraoperative and postoperative complications. Methods: All original studies with reported complication rates were included for analysis. Complications were defined as procedural if secondary to the MI surgery and device related if caused by placement of the implant. Complication rates are reported using descriptive statistics. Random-effects meta-analysis was performed for preoperative and postoperative Visual Analog Score (VAS) pain ratings and Oswestry Disability Index (ODI) scores. Results: Fourteen studies of 720 patients (499 females/221 males) with a mean follow-up of 22 months were included. Ninety-nine patients (13.75%) underwent bilateral SI joint arthrodesis resulting in a total of 819 SI joints fused. There were 91 reported procedural-related complications (11.11%) with the most common adverse event being surgical wound infection/drainage (n = 17). Twenty-five adverse events were attributed to be secondary to placement of the implant (3.05%) with nerve root impingement (n = 13) being the most common. The revision rate was 2.56%. MI SI joint fusion reduced VAS scores from 82.42 (95% confidence interval [CI] 79.34-85.51) to 29.03 (95% CI 25.05-33.01) and ODI scores from 57.44 (95% CI 54.73-60.14) to 29.42 (95% CI 20.62-38.21). Conclusions: MI SI joint fusion is a relatively safe procedure but is not without certain risks. Further work must be done to optimize the procedure’s complication profile. Possible areas of improvement include preoperative patient optimization, operative technique, and use of intraoperative real-time imaging.

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