Clinical Data

26 Patients, 4 year follow-up (Kasapovic - Oper Orthop Traumatol 2021)

[Minimally invasive arthrodesis of the sacroiliac joint (SIJ)]

Kasapovic A, Ali T, Jaenisch M, Rommelspacher Y, Gathen M, Pflugmacher R, Schwetje D.
Oper Orthop Traumatol. 2021 Oct 18. Epub ahead of print. [article in German]
DOI: 10.1007/s00064-021-00738-3. PMID: 34661704.


Objective: Pain reduction and improvement in quality of life with sacroiliac joint (SIJ) fusion.

: Chronic SIJ-associated pain; positive response to SIJ injection with local anesthetic; positive SIJ provocation tests; failed conservative therapy over 6 months.

: Non-SIJ-associated pain; tumor/infection/unstable fracture in the implantation area; malformations; tumor or osteolysis of the sacrum or ilium bone; active infection at the implantation site; allergy to metal components; secondary gain from illness, request for a pension; inadequately treated osteoporosis.

Surgical technique
: Transarticular placement of Kirschner's wires through the SI joint via minimally invasive lateral approach. Guided preparation of implant site over Kirschner's wires and implantation of 3 triangular, transarticular titanium implants for SIJ fusion.

Postoperative management
: Deep vein thrombosis prophylaxis. 3 weeks partial weight-bearing and then moving on to full weight-bearing. X‑ray controls at defined intervals. Physiotherapy.

: We enrolled 26 patients who were followed up over the period of 4 years. The evaluated endpoints were low back pain on the visual analog scale (VAS 0-10), grade of disability with the Oswestry Disability Index (ODI) and quality of life with the EuroQOL-5D. At 4 years, mean low back pain improved compared to preoperative (VAS preoperative 8.4, VAS 4 years postoperative 4.6). Mean improvements in ODI (ODI preoperative 58.1, ODI 4 years postoperative 32.1) and EQ-5D (preoperative 0.5, after 4 years 0.7) could be evaluated over the long-term period of 4 years. Satisfaction rates were high and the proportion of subjects taking opioids decreased at the 4‑year follow-up (preoperative 82%, postoperative 39%). Implant loosening could not be detected on plain radiograph.

: Chronic pain; Low back pain; SIJ fusion; SIJ pain; SIJ syndrome.

Author Information

  • Kasapovic A, Ali T, Jaenisch M, Gathen M, Pflugmacher R - Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
  • Rommelspacher Y - Klinik für Orthopädie, Krankenhaus der Augustinerinnen Köln, Köln, Deutschland.

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