scholarly journals Five-Year Clinical and Radiographic Outcomes After Minimally Invasive Sacroiliac Joint Fusion Using Triangular Implants

2014 ◽  
Vol 8 (1) ◽  
pp. 375-383 ◽  
Author(s):  
Leonard Rudolf ◽  
Robyn Capobianco
Keyword(s):  
Minimally Invasive ◽  
Sacroiliac Joint ◽  
Porous Titanium ◽  
Implant Loosening ◽  
X Ray ◽  
Radiographic Outcomes ◽  
Joint Fusion ◽  
Lumbar Spinal ◽  
Si Joint

Object : Previous reports of minimally invasive (MIS) sacroiliac (SI) joint fusion for low back, SI joint, and buttock pain secondary to SI joint disorders have shown favorable short- and mid-term outcomes. Herein we present 5-year clinical and radiographic outcomes after MIS SI joint fusion using a series of triangular porous titanium plasma spray (TPS) coated implants. Methods : Consecutive patients treated with MIS SI joint fusion for degenerative sacroiliitis and/or sacroiliac joint disruptions between October 2007 and March 2009 were evaluated. Pain on VAS, an SI joint specific survey and Oswestry Disability Index (ODI) were administered. X-ray and CT scans were obtained to assess the implants. Results : Of 21 patients treated, 17 were available for the study. Mean age was 58 years (range 36-85), 77% were female and 47% had prior lumbar spinal fusion. Pain on VAS improved from 8.3 at baseline to 2.4 at 5 years; 88% of patients reached Substantial Clinical Benefit. Mean ODI score at 5 years was 21.5 (SD 22.7). Patient satisfaction achieved at 12 months was maintained for 5 years (82%). A qualitative review of x-ray and CT imaging showed increased bone density immediately adjacent to all implants, intra-articular osseous bridging in 87% of patients and no evidence of implant loosening or migration. Conclusion : Long-term clinical and radiographic outcomes after MIS SIJ fusion are favorable. Clinical improvements observed at 12 months postoperatively were maintained at 5 years. There was no evidence of long-term complications, implant loosening or migration. Patients who did not achieve large improvements were affected by multiple severe concomitant degenerative conditions of the lumbar spine, pelvis, and/or hip.

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

Sacroiliac Joint Fusion: Percutaneous and Open

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.

scholarly journals Durable intermediate- to long-term outcomes after minimally invasive transiliac sacroiliac joint fusion using triangular titanium implants

2016 ◽  
Vol Volume 9 ◽  
pp. 213-222 ◽  
Author(s):  
Donald Sachs ◽  
Don Kovalsky ◽  
Andy Redmond ◽  
Robert Limoni ◽  
S. Craig Meyer ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Sacroiliac Joint ◽  
Titanium Implants ◽  
Long Term Outcomes ◽  
Joint Fusion ◽  
Sacroiliac Joint Fusion

scholarly journals Long-term prospective outcomes after minimally invasive trans-iliac sacroiliac joint fusion using triangular titanium implants

2018 ◽  
Vol Volume 11 ◽  
pp. 113-121
Author(s):  
Emily Darr ◽  
S. Craig Meyer ◽  
Peter Whang ◽  
Don Kovalsky ◽  
Clay Frank ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Sacroiliac Joint ◽  
Titanium Implants ◽  
Joint Fusion ◽  
Sacroiliac Joint Fusion

scholarly journals Sacroiliac Joint Fusion: One Year Clinical and Radiographic Results Following Minimally Invasive Sacroiliac Joint Fusion Surgery

2016 ◽  
Vol 10 (1) ◽  
pp. 679-689 ◽  
Author(s):  
Richard A. Kube ◽  
Jeffrey M. Muir
Keyword(s):  
Minimally Invasive ◽  
Sacroiliac Joint ◽  
Joint Pain ◽  
Fusion Rate ◽  
Leg Pain ◽  
Post Procedure ◽  
Joint Fusion ◽  
One Year ◽  
Sacroiliac Joint Fusion ◽  
Si Joint

Background:Recalcitrant sacroiliac joint pain responds well to minimally-invasive surgical (MIS) techniques, although long-term radiographic and fusion data are limited.Objective:To evaluate the one-year clinical results from a cohort of patients with chronic sacroiliac (SI) joint pain unresponsive to conservative therapies who have undergone minimally invasive SI joint fusion.Methods:SI joint fusion was performed between May 2011 and January 2014. Outcomes included radiographic assessment of fusion status, leg and back pain severityviavisual analog scale (VAS), disabilityviaOswestry Disability Index (ODI) and complication rate. Outcomes were measured at baseline and at follow-up appointments 6 months and 12 months post-procedure.Results:Twenty minimally invasive SI joint fusion procedures were performed on 18 patients (mean age: 47.2 (14.2), mean BMI: 29.4 (5.3), 56% female). At 12 months, the overall fusion rate was 88%. Back and leg pain improved from 81.7 to 44.1 points (p<0.001) and from 63.6 to 27.7 points (p=0.001), respectively. Disability scores improved from 61.0 to 40.5 (p=0.009). Despite a cohort containing patients with multiple comorbidities and work-related injuries, eight patients (50%) achieved the minimal clinically important difference (MCID) in back pain at 12 months, with 9 (69%) patients realizing this improvement in leg pain and 8 (57%) realizing the MCID in ODI scores at 12 months. No major complications were reported.Conclusion:Minimally invasive SI joint surgery is a safe and effective procedure, with a high fusion rate, a satisfactory safety profile and significant improvements in pain severity and disability reported through 12 months post-procedure.

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