160 Patients, 1-year Follow-up (Rainov - Eur Spine J 2018)
Triangular Titanium Implants for Sacroiliac Joint Fusion
Rainov NG, Schneiderhan R, Heidecke V.
Eur Spine J. 2018 Dec 18. [Epub].
DOI: 10.1007/s00586-018-5860-1. PMID: 30564865.
Background: Sacroiliac joint (SIJ) dysfunction is an underdiagnosed condition. Several published cohorts have reported favorable midterm outcomes after SIJ fusion using titanium implants placed across the SIJ. Herein, we report 12-month follow-up from SIJ fusion in a standard clinic setting.
Methods: A carefully selected group of 160 consecutive patients with painful SIJ dysfunction were diagnosed at a single center and underwent unilateral or staged bilateral SIJ fusion using triangular titanium implants. Patients were routinely seen in clinic for follow-up every 3 months where they completed visual analog scale (0-10 range) pain ratings and Oswestry Disability Index (ODI). Follow-up CT scan was performed at 1 year.
Results: Mean patient age was 58 years, and 68% were women. 30% underwent staged bilateral SIJ fusion. By month 12, SIJ pain decreased from 8.0 to 2.5 (p < 0.0001) and disability (ODI) decreased from 45.3 to 16.4 (p < 0.0001). The proportion with clinically significant improvements in SIJ pain and ODI was high (> 95%). Perioperative adverse events were mild and decreased with increasing surgical experience with the procedure. Subgroup analysis showed slightly smaller improvements in those undergoing bilateral surgery and those with a spinal cord stimulator in place. CT scan at 1 year showed reabsorption along one or more implants in 16% of cases, but there were no breakages or implant removals.
Conclusions: In standard clinical practice, SIJ fusion with triangular titanium implants produces significant improvement in pain and disability related to SIJ dysfunction. These slides can be retrieved under Electronic Supplementary Material.
KEYWORDS: Degenerative sacroiliitis; Minimally invasive surgery; Sacroiliac joint arthrodesis; Sacroiliac joint disruptions; Sacroiliac joint dysfunction; Spine surgery
Rainov NG, Schneiderhan R - MVZ Wirbelsäulenzentrum Taufkirchen b. München, Eschenstr. 2, 82024, Taufkirchen, Munich, Germany.
Heidecke V - Klinik für Neurochirurgie, Klinikum Augsburg, 86156, Augsburg, Germany.