Abstract
Increased interest in the sacroiliac joint (SIJ) as a contributor to chronic low back pain has resulted in an expanding set of surgical and nonsurgical treatment options. Evidence for the effectiveness of nonsurgical treatment is limited, impeding assessment of the overall value of such treatments. For surgical treatment, only triangular titanium implants, used during minimally invasive SIJ fusion, have been the subject of rigorous clinical and economic evaluations. Randomized trials of triangular titanium implants have shown marked immediate and sustained improvements in pain, disability, and quality of life with incremental cost-effectiveness ratios that are at least as good as high-volume orthopedic procedures and lower than those for other spine surgeries. Other devices for SIJ fusion are available but the limited evidence base prevents any conclusions regarding those devices.
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