Safety and effectiveness of minimally invasive sacroiliac joint fusion in women with persistent post‑partum posterior pelvic girdle pain: 12‑month outcomes from a prospective, multi‑center trial
Capobianco R, et al. SpringerPlus (2015) 4:570.
Postpartum posterior pelvic girdle pain (PPGP) affects nearly 20 % of women who experience back pain in the peripartum period. The sacroiliac joint is a source of this pain in 75 % of women with persistent PPGP. A subset of women will fail to obtain acceptable pain relief from the current array of non-surgical treatment options. The purpose of this study is to assess the safety and effectiveness of minimally invasive sacroiliac (SI) joint fusion in women with chronic SI joint dysfunction whose pain began in the peri-partum period whose symptoms were recalcitrant to non-surgical management. A sub-group analysis of subjects with sacroiliac joint disruption and/or degenerative sacroiliitis enrolled in a prospective, multi-center trial of SI joint fusion was performed. Subjects with PPGP were identified and compared with women without PPGP and with men. Of 172 enrolled subjects, 52 were male, 100 were females without PPGP and 20 females had PPGP. PPGP subjects were significantly younger (43.3 years, vs. 52.8 for females without PPGP and 50.5 for men, p = 0.002). There were no differences in any other demographic or baseline clinical measure. Women with PPGP experienced a significant improvement in pain (−51 mm on VAS), function (−20.6 pts on ODI) and quality of life (SF-36 PCS +10.4, MCS +7.2, EQ-5D +0.31) at 12 months after surgery. These improvements were characteristic of the overall study results; no difference was detected between sub-groups. The sacroiliac joint can be a source of pain in women with persistent PPGP and should be investigated as a pain generator. In this study, women with carefully diagnosed chronic SI joint pain from PPGP recalcitrant to conservative therapies experienced clinically beneficially improvements in pain, disability and quality of life after minimally invasive SI joint fusion using a series of triangular porous plasma spray coated implants.
Keywords: Sacroiliac joint fusion, Postpartum pelvic girdle pain, Sacroiliac joint dysfunction, Sacroiliac joint disruption, Degenerative sacroiliitis
Robyn Capobianco*, Daniel Cher* and for the SIFI Study Group
*Current or former employees of SI-BONE, Inc., 3055 Olin Ave Suite 2200, San Jose, CA 95128, USA
SI-BONE sponsored the prospective clinical trial that provided data on SI joint patients described herein. Robyn Capobianco and Daniel Cher are employees of SI-BONE, Inc.