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

2018 ◽  
Vol 12 (1) ◽  
pp. 7-16 ◽  
Author(s):  
William W Cross ◽  
Arnold Delbridge ◽  
Donald Hales ◽  
Louis C Fielding
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Minimally Invasive ◽  
Sacroiliac Joint ◽  
Pain Scale ◽  
Common Source ◽  
Fusion System ◽  
Low Back ◽  
Solid Fusion ◽  
Sacroiliac Joint Fusion

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.

scholarly journals Use of Ultrasound-Guided Platelet-Rich Plasma Injection of the Sacroiliac Joint as a Treatment for Chronic Low Back Pain

2019 ◽  
Vol 185 (7-8) ◽  
pp. e1312-e1317
Author(s):  
Devin Y Broadhead ◽  
Hannah E Douglas ◽  
Laurie M Bezjian Wallace ◽  
Patrick J Wallace ◽  
Sarah Tamura ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Sacroiliac Joint ◽  
Functional Disability ◽  
Platelet Rich Plasma ◽  
Common Source ◽  
Low Back ◽  
Ultrasound Guided ◽  
Long Term Treatment

ABSTRACT Back pain and its associated complications are of increasing importance among military members. The sacroiliac joint (SIJ) is a common source of chronic low back pain (LBP) and functional disability. Many patients suffering from chronic LBP utilize opioids to help control their symptoms. Platelet-rich plasma (PRP) has been used extensively to treat pain emanating from many different musculoskeletal origins; however, its use in the SIJ has been studied only on a limited basis. The patient in this case report presented with chronic LBP localized to the SIJ and subsequent functional disability managed with high-dose opioids. After failure of traditional treatments, she was given an ultrasound-guided PRP injection of the SIJ which drastically decreased her pain and disability and eventually allowed for complete opioid cessation. Her symptom relief continued 1 year after the injection. This case demonstrates the potential of ultrasound-guided PRP injections as a long-term treatment for chronic LBP caused by SIJ dysfunction in military service members, which can also aid in the weaning of chronic opioid use.

scholarly journals Sacroiliac joint fusion VS conservative management for chronic low back pain attributed to the sacroiliac joint

Medicine ◽  
2020 ◽  
Vol 99 (46) ◽  
pp. e23223
Author(s):  
Li-Ye Chen ◽  
Hao-Dong Liang ◽  
Qi-Ning Qin ◽  
Tian-Zhao Tian ◽  
Bao-Xin Liu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Conservative Management ◽  
Chronic Low Back Pain ◽  
Sacroiliac Joint ◽  
Low Back ◽  
Joint Fusion ◽  
Sacroiliac Joint Fusion

Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis

2016 ◽  
Vol 25 (6) ◽  
pp. 1924-1931 ◽  
Author(s):  
Kiran Kumar Lingutla ◽  
Raymond Pollock ◽  
Sashin Ahuja
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Meta Analysis ◽  
Low Back ◽  
Joint Fusion ◽  
Sacroiliac Joint Fusion

scholarly journals Endoscopic Radiofrequency Treatment of the Sacroiliac Joint Complex for Low Back Pain: A Prospective Study with a 2-Year Follow-Up

2019 ◽  
Vol 2 (22.2) ◽  
pp. E111-E118
Author(s):  
Albert E. Telfeian
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Sacroiliac Joint ◽  
Sensory Nerve ◽  
Case Series ◽  
Low Back ◽  
Radiofrequency Treatment ◽  
Si Joint

Background: The sacroiliac joint complex (SIJC) is considered a major sources of chronic low back pain. Interventional procedures for sacroiliac (SI) joint pain tend to be short-lived and surgical treatment usually involves a fusion procedure. Objectives: To determine the clinical efficacy of endoscopically visualized radiofrequency treatment of the SIJC in the treatment of low back pain. Study Design: Retrospective chart review. Setting: This study took place in a single-center, orthopedic specialty hospital. Methods: Patients received general anesthesia and under endoscopic visualization, radiofrequency ablation was performed on 1) the perforating branches that innervate the posterior capsule of the SI joint capsule, 2) along the course of the long posterior SI ligament, 3) the lateral edges of the S1, S2, and S3 foramen, and 4) the L4, L5, and S1 medial marginal nerve branches along the lateral facet margins. Results: From January 2015 to June 2016, a total of 30 patients who met the precise inclusion criteria were treated with the endoscopic SIJC radiofrequency treatment for low back pain. The average patient was aged 56 years (19 women and 11 men), the average preoperative visual analog scale (VAS) score was 7.23, and the average Oswestry disability index (ODI) score was 44.8. VAS and ODI were measured at 3, 6, 9, 12, 15, 21 and 24 months: VAS was reduced from 7.23 at baseline to 2.82 at 24 months (61% reduction), and ODI was improved from 44.8 at baseline to 22.2 at 24 months (50% reduction). Limitations: Small retrospective case series. Conclusions: Full-endoscopic radiofrequency ablation of the large sensory SI joint innervation complex, that includes the sensory nerve branches along the lateral S1-3 foramina and the L4-S1 medial branches, is perhaps a minimally invasive surgical procedure that could provide significant relief of lumbar back pain in the carefully selected patient. Key words: Endoscopic spine surgery, minimally invasive, low back pain, sacroiliac joint, radiofrequency treatment

scholarly journals Sacroiliac Joint Ligaments and Sacroiliac Pain: A Case–Control Study on Micro- and Ultrastructural Findings on Morphologic Alterations

2019 ◽  
Vol 6 (22;6) ◽  
pp. E615-E625 ◽  
Author(s):  
Niels Hammer
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Case Control Study ◽  
Case Control ◽  
Small Sample ◽  
Common Source ◽  
Low Back ◽  
History Of ◽  
Control Study

Background: The sacroiliac joint (SIJ) is a common source of low back pain. SIJ pain has shown to have negative impact on patients’ quality of life. Although clinically there is an increasing interest to treat SIJ-related pain both conservatively and surgically, the underlying mechanisms related to pathology in that region are poorly understood. One hypothesis is that the SIJ ligaments are structurally altered in SIJ pain. Objectives: The given study investigated patient cases with different pain durations undergoing posterior distraction arthrodesis of the SIJ, with subsequent micro- and ultrastructural assessment of the interosseous and posterior SIJ ligaments compared with autopsy controls without known history of low back pain. Study Design: Case–control study. Morphologic-pathological analysis of tissue samples obtained during surgery with controls from legal medicine. Setting: Rural hospital setting in Halberstadt, Germany. Methods: SIJ ligaments were removed from 6 patients undergoing SIJ arthrodesis for histological and ultrastructural assessment in scanning and transmission electron microscopy, and compared with 6 controls without known history of SIJ pathology. Results: A number of alterations were observed in the ligaments of patients with SIJ, namely ligament disruption, collagen loosening and coiling, vascularization, and hemorrhage. In some areas, these changes were observed in proximity to healthy (structurally unaltered and intact tissues), indicative of a potential disease progression. Comparison to controls yielded a significant correlation between SIJ pathology and the level of collagen degeneration (φ ≥ 0.82; P < 0.001). Limitations: Small sample size, method of tissue removal from patients may have influenced tissue integrity. Conclusions: The combined clinical, histological, and ultrastructural analysis provided, to our knowledge, first-time evidence of morphologic SIJ ligament alteration of a nontraumatic and noninflammatory cause. Further research is necessary to elucidate these structural changes and to substantiate pain duration and patient-history-dependent changes at the ligaments of the posterior pelvis

Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis

2015 ◽  
Vol 15 (3) ◽  
pp. S54
Author(s):  
Kiran Lingutla ◽  
Suribabu Gudipati ◽  
Raymond Pollock ◽  
Sashin Ahuja
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Meta Analysis ◽  
Low Back ◽  
Joint Fusion ◽  
Sacroiliac Joint Fusion

scholarly journals Double Needle Technique: An Alternative Method for Performing Difficult Sacroiliac Joint Injections

2011 ◽  
Vol 3;14 (3;5) ◽  
pp. 281-284
Author(s):  
Sanjeeva Gupta
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sacroiliac Joint ◽  
Joint Line ◽  
Complex Nature ◽  
Common Source ◽  
Low Back ◽  
Needle Technique ◽  
Large Joint ◽  
The Right

The sacroiliac joint (SIJ) is a common source of low back pain. The most appropriate method of confirming SIJ pain is to inject local anesthesia into the joint to find out if the pain decreases. Unfortunately, although the SIJ is a large joint, it can be difficult to enter due to the complex nature of the joint and variations in anatomy. In my experience a double needle technique for sacroiliac joint injection can increase the chances of accurate injection into the SIJ in difficult cases. After obtaining appropriate fluoroscopic images, the tip of the needle is advanced into the SIJ. Once the tip of the needle is correctly placed, its position is checked under continuous fluoroscopy while moving the C-arm in the right and left oblique directions (dynamic fluoroscopy). On dynamic fluoroscopy the tip of the needle should remain within the joint line and not appear to be on the bone. If the tip of the needle appears to be on the bone a new joint line will need to be identified (the most translucent area through the joint) by dynamic fluoroscopy and another needle advanced into the newly identified joint line. Dynamic fluoroscopy is repeated again to confirm that the tip of the second needle remains within the joint line. Once both needles are in place contrast dye is injected through the needle that is most likely to be in the SIJ. If the contrast dye spread is not satisfactory then it is injected through the other needle. I have used this technique in 10 patients and found it very helpful in accurately performing SIJ injection which can at times be challenging. Key words: double needle techique, sacroiliac joint, low back pain, contrast dye, fluoroscopy

Treatment of Refractory Low Back Pain Caused by Degenerative Spine Disease with Minimally Invasive Techniques

2014 ◽  
Vol 4 (1_suppl) ◽  
pp. s-0034-1376724-s-0034-1376724
Author(s):  
K. Vladimirovich Tyulikov ◽  
K. Korostelev ◽  
V. Manukovsky ◽  
V. Litvinenko ◽  
V. Badalov
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Minimally Invasive ◽  
Low Back ◽  
Minimally Invasive Techniques ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Invasive Techniques ◽  
Spine Disease
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