Ignoring the sacroiliac joint in chronic low back pain is costly

Polly DW, Cher DJ. Clinicoecon Outcomes Res. 2016;8:23-31. Published online 2016 Jan 21.

Background: Increasing evidence supports minimally invasive sacroiliac joint (SIJ) fusion as a safe and effective treatment for SIJ dysfunction. Failure to include the SIJ in the diagnostic evaluation of low back pain could result in unnecessary health care expenses.

Design: Decision analytic cost model.

Methods: A decision analytic model calculating 2-year direct health care costs in patients with chronic low back pain considering lumbar fusion surgery was used.

Results: The strategy of including the SIJ in the preoperative diagnostic workup of chronic low back pain saves an expected US$3,100 per patient over 2 years. Cost savings were robust to reasonable ranges for costs and probabilities, such as the probability of diagnosis and the probability of successful surgical treatment.

Conclusion: Including the SIJ as part of the diagnostic strategy in preoperative patients with chronic low back pain is likely to be cost saving in the short term.

Disclosure: Dr. Polly is an investigator on a clinical research study sponsored by SI-BONE. He has no financial interest in SI-BONE. Daniel Cher is an SI-BONE employee. SI-BONE sponsored the clinical trial from which data were used in the reported model. SI-BONE manufactures the implant used in the SIJF surgery studied. The authors report no other conflicts of interest in this work