RESEARCH ARTICLE


Minimally Invasive Sacroiliac Joint Fusion: 2-Year Radiographic and Clinical Outcomes with a Principles-Based SIJ Fusion System



William W Cross1, Arnold Delbridge2, Donald Hales3, Louis C Fielding4, *
1 Mayo Clinic Rochester, Minnesota, MN 55905, United States
2 Cedar Valley Medical Specialists PC Waterloo, Iowa, IA 50704, United States
3 Northern Arizona Orthopaedics Flagstaff, Arizona, AZ 86001, United States
4 Tahoe Labs, LLC 1057 Montgomery St., San Carlos, California, 94070, United States


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© 2018 Cross et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Tahoe Labs, LLC, 1057 Montgomery St., San Carlos, California 94070, United States; Tel: +1 206-953-9839; Fax: +1 650-585-6307; E-mail: tahoelabs@gmail.com


Abstract

Background:

Sacroiliac joint (SIJ) degeneration is a common source of low back pain (LBP). Minimally invasive (MI) SIJ fusion procedures have demonstrated meaningful clinical improvement. A recently developed MI SIJ fusion system incorporates decortication, placement of bone graft and fixation with threaded implants (DC/BG/TF).

Patients and Methods:

Nineteen patients who had MI SIJ fusion with DC/BG/TF were enrolled at three centers. Fusion was assessed in CT images obtained 12 and 24 months postoperatively by an independent radiographic core laboratory. LBP was assessed using a 0-10 numerical pain scale (NPS) preoperatively and at 12 and 24 months postoperatively.

Results:

At 12 months, 15/19 patients (79%) had bridging bone across the SIJ, and at 24 months 17/18 patients (94%) available for follow-up had SIJ fusion. Of the patients with bridging bone 88% had fusion within the decorticated area, with solid fusion in 83%. A significant reduction in NPS scores was demonstrated, representing a 73% reduction in average low back pain.

Conclusion:

The patients in this series demonstrated significant improvement in LBP. Fusion rates at 24 months demonstrate promise for this system, which utilizes the established orthopedic principles of DC/BG/TF to achieve arthrodesis. Further study is warranted to demonstrate comparative fusion rates for different implant systems.

Keywords: Sacroiliac joint, Sacroiliac fusion, Decortication, Minimally invasive, Fusion, Radiographic fusion, Bridging bone, Low back pain.