Abstract
Design:Independent retrospective review of a single surgeon’s experience with a new technique of SI fixation.Objective:Examine results of percutaneous fixation of the SI joint with porous coated triangular titanium implants.Background:Diagnosis and treatment of a dysfunctional sacroiliac joint is challenging as well as controversial. Recently, percutaneous stabilization techniques have been implemented for fixation. There is minimal literature published on this technique.Methods:Charts, radiographs, and CT scans of 31 patients operated on by a single surgeon were de-identified and randomized and then reviewed by investigators not involved with the care of the patients. Reviewers had no relationship with the implant manufacturer at the time of the review. Outcome Measures: intraoperative and postoperative complication, EBL, hospital stays, postoperative image location and number of lucent implants, ingrowth into implants, and bone across SI joint.Results:27 patients expressed satisfaction, 4 patients did not. Pain relief was noted to be Complete (16 patients), Excellent (5 patients), Good (9 patients), and Fair (1 patients). Four patients had postoperative complications. These were infected hematoma (2), L5 nerve root irritation (1), and L5-S1 discitis (1). One patient required revision. On 6 month postop CT scan, 18/19 patients had radiographic evidence of bone ingrowth and bone into or across the SI joint was evident in 8/19 patients. Lucency was noted around at least one implant in 5/19 patients.Conclusions:Results are promising for the use of this novel implant for a carefully selected group of patients with disabling SI dysfunction.
Highlights
Complexity of diagnosis and controversy in treatment make sacroiliac (SI) joint pain a challenging condition to manage
Literature has shown that the SI joint is a legitimate pain generator in patients with low back pain (LBP) still underappreciated [1]
Some investigators have advocated for SI joint arthrodesis for patients with chronic and debilitating SI joint pain [3]
Summary
Complexity of diagnosis and controversy in treatment make sacroiliac (SI) joint pain a challenging condition to manage. Literature has shown that the SI joint is a legitimate pain generator in patients with low back pain (LBP) still underappreciated [1]. The majority of patients with SI joint pain can be treated non operatively. When these treatments fail, some investigators have advocated for SI joint arthrodesis for patients with chronic and debilitating SI joint pain [3]. SI joint arthrodesis studies exist that report a varying degree of success, most being satisfactory, for treating chronic and debilitating SI joint pain. Diagnosis and treatment of a dysfunctional sacroiliac joint is challenging as well as controversial.
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