Pelvic joint fusion in patients with severe pelvic girdle pain – a prospective single-subject research design study

Thomas J Kibsgård,Olav Røise,Britt Stuge

doi:10.1186/1471-2474-15-85

Thomas J Kibsgård, Olav Røise + Show 1 more

Open Access

https://doi.org/10.1186/1471-2474-15-85

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Abstract

BackgroundThe fusion of the pelvic joints in patients with severe pelvic girdle pain (PGP) is a controversial and insufficiently studied procedure. The aims of this study were to evaluate physical function and pain after sacroiliac joint (SIJ) fusion.MethodsA single-subject research design study with repeated measurements was conducted; pre-operatively and at 3, 6 and 12 months post-operatively. The outcome measures considered were the Oswestry disability index (ODI), visual analogue scale (VAS), and SF-36. Eight patients with severe PGP received open-accessed unilateral anterior SIJ fusion and fusion of the pubic symphysis.ResultsSeven patients reported positive results from the surgery. At 1 year post-operation, significant (p < 0.001) reductions in ODI (54 to 37) and VAS (82 to 57) were reported. The physical functioning, bodily pain, and social functioning scores in the SF-36 were also improved.ConclusionPositive and significant changes in disability and pain at 1 year after SIJ fusion were observed. Despite these positive results, open accessed anterior fusion of the SIJ was associated with adverse events and complications such as infection and nerve damage.

Highlights

The fusion of the pelvic joints in patients with severe pelvic girdle pain (PGP) is a controversial and insufficiently studied procedure
It has become increasingly clear that patients with PGP have a different clinical presentation than patients suffering from low back pain [6]
Based on previous findings that female patients with PGP have variations in pain intensity during their menstrual cycle [17], the patients filled out a questionnaire every Thursday for 5 weeks in each phase to ensure that evaluations were made throughout the menstrual cycle

Summary

Introduction

The fusion of the pelvic joints in patients with severe pelvic girdle pain (PGP) is a controversial and insufficiently studied procedure. The sacroiliac joint (SIJ) may be the source of pain for 13-30% of patients with low back pain [1], and possibly an even higher proportion of patients suffering from “failed back surgery” [2,3]. This pain may be caused by specific pathology of the joint [4], but the specific role of the SIJ in unspecific pelvic girdle pain (PGP) disorder remains unknown.

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