Clinical Data
MIS SI Joint Fusion, 29 patients, 1-year results (Hermans - J Orthop Surg Res 2022)
Double-center observational study of minimally invasive sacroiliac joint fusion for sacroiliac joint dysfunction: one-year results.
Hermans SMM, Knoef RJH, Schuermans VNE, Schotanus MGM, Nellensteijn JM, van Santbrink H, Curfs I, van Hemert WLW.
J Orthop Surg Res. 2022 Dec 28;17(1):570.
DOI: 10.1186/s13018-022-03466-x. PMID: 36575465; PMCID: PMC9794474.
ABSTRACT
Background: For a substantial part of patients with chronic low back pain, the origin is located in the sacroiliac joint (SIJ). Minimally invasive sacroiliac joint fusion (MISJF) is increasingly being implemented as a treatment option in SIJ dysfunction. Despite remaining controversy, evidence continues to increase. This study evaluates the clinical results and safety of MISJF in a double-center consecutive case series in patients with SIJ dysfunction over a one-year observation period.
Methods: SIJ complaints were diagnosed after history taking, physical examination and least a 50% reduction of SIJ pain 30-60 min following image-guided injection. Primary outcome measures were patient reported outcome measurements (PROMs), consisting of Visual Analogue Scale (VAS) pain score and EuroQol 5-dimensions 3-levels (EQ-5D-3L). Patients' perspectives on the effects of surgery were collected through questionnaires. Secondary outcome measures were implant positioning and (serious) adverse events ((S)AE's).
Results: A total of 29 patients were included. In 44.8% of patients, SIJ dysfunction was of postpartum origin. The mean VAS-pain score improved from 7.83 (± 1.71) to 4.97 (± 2.63) postoperatively (p < 0.001). EQ-5D-3L score improved from 0.266 (± 0.129) to 0.499 (± 0.260) postoperatively (p < 0.001). Opioid consumption decreased from 44.8 to 24.1% postoperatively (p = 0.026). In 13.7% of patients, an (S)AE occurred.
Discussion: Minimally invasive sacroiliac fusion resulted in an improvement in mean functional scores with a wide dispersion. Patients not achieving MCID are patients with either a malpositioned implant, an associated lumbar pathology, or an inaccurate diagnosis. Our results are underwhelming compared to similar work but are still better than conservative cohorts in comparative studies.
Conclusions: MISJF appears to be an effective and safe procedure in this cohort. Statistically significant and clinically relevant improvements in pain and quality of life were observed one-year postoperatively. Future studies should focus on the long-term outcomes to further evaluate the safety and effectiveness of MISJF.
Author Information
- Hermans SMM - Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Heerlen, The Netherlands. semhermans@hotmail.com;
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. - Knoef RJH, Nellensteijn JM - Department of Orthopaedic Surgery, Medical Spectrum Twente, Enschede, The Netherlands.
- Schuermans VNE, van Santbrink H - Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Department of Neurosurgery, Maastricht University Medical Center +, Maastricht, The Netherlands; Department of Neurosurgery, Zuyderland Medical Center, Heerlen, The Netherlands.
- Schotanus MGM - Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands; Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Heerlen, The Netherlands.
- Curfs I, van Hemert WLW - Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Heerlen, The Netherlands.