Complications and their management

Mapping Intimacies ◽

10.1093/med/9780197607947.003.0022 ◽

2021 ◽

pp. 243-246

Author(s):

Hemant Kalia

Keyword(s):

Minimally Invasive ◽

Sacroiliac Joint ◽

Posterior Approach ◽

Lateral Approach ◽

Minimally Invasive Surgical ◽

Joint Fusion ◽

Surgical Fusion ◽

Sacroiliac Joint Fusion ◽

Open Surgical Approach ◽

Pain Generator

This chapter reviews the complications that can occur after minimally invasive surgical fusion of the sacroiliac joint, focusing on infection and neurovascular injuries and their prevention and treatment. The sacroiliac joint has been identified as a potential pain generator in 15% to 30% of chronic low back pain and post-laminectomy syndrome patients. Minimally invasive sacroiliac joint fusion via the lateral approach is effective and better tolerated than the open surgical approach. Most of the current studies have focused on efficacy and patient satisfaction as opposed to the safety profile of the procedure. There is a dearth of literature regarding the safety of minimally invasive sacroiliac joint fusion. Over the past few years, a novel posterior approach to sacroiliac joint fusion has become more common that theoretically is safer and potentially as efficacious as the lateral approach.

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International Society for the Advancement of Spine Surgery Policy 2020 Update—Minimally Invasive Surgical Sacroiliac Joint Fusion (for Chronic Sacroiliac Joint Pain): Coverage Indications, Limitations, and Medical Necessity

The International Journal of Spine Surgery ◽

10.14444/7156 ◽

2020 ◽

pp. 7156

Author(s):

Morgan Lorio ◽

Richard Kube ◽

Ali Araghi

Keyword(s):

Minimally Invasive ◽

Spine Surgery ◽

International Society ◽

Sacroiliac Joint ◽

Joint Pain ◽

Medical Necessity ◽

Sacroiliac Joint Pain ◽

Minimally Invasive Surgical ◽

Joint Fusion ◽

Sacroiliac Joint Fusion

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Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint

Advances in Orthopedics ◽

10.1155/2014/154041 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Michael Woods ◽

Denise Birkholz ◽

Regina MacBarb ◽

Robyn Capobianco ◽

Adam Woods

Keyword(s):

Minimally Invasive ◽

Sacroiliac Joint ◽

Case Series ◽

Intraoperative Neuromonitoring ◽

Direct Result ◽

Retrospective Case ◽

Minimally Invasive Surgical ◽

Joint Fusion ◽

Neurologic Sequelae ◽

Sacroiliac Joint Fusion

Study Design. Retrospective case series.Objective. To document the clinical utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion for patients diagnosed with sacroiliac joint dysfunction (as a direct result of sacroiliac joint disruptions or degenerative sacroiliitis) and determine stimulated electromyography thresholds reflective of favorable implant position.Summary of Background Data. Intraoperative neuromonitoring is a well-accepted adjunct to minimally invasive pedicle screw placement. The utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion using a series of triangular, titanium porous plasma coated implants has not been evaluated.Methods. A medical chart review of consecutive patients treated with minimally invasive surgical sacroiliac joint fusion was undertaken at a single center. Baseline patient demographics and medical history, intraoperative electromyography thresholds, and perioperative adverse events were collected after obtaining IRB approval.Results. 111 implants were placed in 37 patients. Sensitivity of EMG was 80% and specificity was 97%. Intraoperative neuromonitoring potentially avoided neurologic sequelae as a result of improper positioning in 7% of implants.Conclusions. The results of this study suggest that intraoperative neuromonitoring may be a useful adjunct to minimally invasive surgical sacroiliac joint fusion in avoiding nerve injury during implant placement.

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Sacroiliac Joint Fusion: Percutaneous and Open

10.1093/med/9780199350940.003.0020 ◽

2018 ◽

Author(s):

Daraspreet Singh Kainth ◽

Karanpal Singh Dhaliwal ◽

David W. Polly

Keyword(s):

Back Pain ◽

Minimally Invasive ◽

Sacroiliac Joint ◽

Surgical Techniques ◽

Nonoperative Treatment ◽

Minimally Invasive Surgical ◽

Joint Fusion ◽

Sacroiliac Joint Fusion ◽

Invasive Techniques

Sacroiliac joint (SIJ) pain is the source of back pain in up to 25% of patients presenting with back pain. There is significant individual variation in the anatomy of the sacrum and the lumbosacral junction. SIJ pain is diagnosed with the history and physical examination. SIJ injection of a local anesthetic along with steroids is often used to confirm the diagnosis. Nonoperative treatment includes nonsteroidal anti-inflammatories, physical therapy, joint manipulation therapies, and SIJ injections. SIJ pain can also be successfully treated with radiofrequency ablation in some patients. Surgical treatment includes the open anterior sacroiliac joint fusion technique and minimally invasive techniques. The benefits of minimally invasive SIJ fusion versus open surgery include less blood loss, decreased surgical time, and shorter hospital stay. Further studies are needed to determine the long-term durability of the minimally invasive surgical techniques.

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