Simplifying Sacroiliac Joint Arthrodesis Using Fusion Implants
Mark A. Reiley, M.D., Leonard M. Rudolf, M.D. Abstract Presented at the 7th Annual Meeting “Innovative Techniques in Spine Surgery” in Cabo, June 2010
SIMPLIFYING SACROILIAC JOINT ARTHRODESIS USING FUSION IMPLANTS
Mark A. Reiley, MD and Leonard M. Rudolf, MD
Introduction
According to Bernard & Kirkaldy-Willis (1987), 22% of patients presenting with
LBP actually have SI joint problems.
Fig.1. AP & Lat x-rays of Fusion Implant treatment of the SI Joint.
In response, an MIS implant was developed to treat the SI joint (Fig.1). This MIS procedure uses Ti implants coated with a plasma spray. Their size and metallurgy produce strong surgical constructs. Similar implants have been used in >1,000 subtalar fusions.
Method
20 patients were dx’ed with SI joint pain using CT-guided injection. The 7.0mm triangular implants were inserted through a 3cm incision under general in a prone position. Implants range from 35 to 55mm in 5mm increments. Tools and implants are cannulated to allow precise implantation. 3 or 4 fusion implants were inserted depending on patient size. PO patients were NWB for up to 8 wks, PWB for 4 wks, and WBAT at 12 wks.
Results
Modified SF-12 showed decrease symptoms from a pre-op mean of 8.2 to 1.2 at
12 and 18 mos. PO films included 3, 12, & 24 mo X-rays. CT was performed at
3, 12, & 24 mos to observe bone growth across the joint. 90% of patients said they would have the operation again.
Complications
3 minor hematomas were observed and 1 arterial injection required.
Discussion
Early evaluation of 20 patients with SI joint problems shows promise for treatment of LBP due to SI joint.
