Sacroiliac joint fusion: a systematic review

Abstract

Background Sacroiliac joint (SIJ) fusion represents a unique area of orthopedic surgery with procedural literature dating to the early 1920s, showing limited innovation in either technique or hardware over the past 90 years. Recent improvements in the diagnosis and treatment of SIJ dysfunction warrant comparisons with older surgical techniques. Aim and objectives This systematic review aimed to evaluate the efficacy and safety of SIJ fusion, whether open or minimally invasive, for the management of chronic low back pain. Materials and methods This was a systematic review and metaanalysis. The electronic databases up to June 2019 of ‘Pub med Medline,’ ‘EMbase,’ and ‘Google Scholar’ were explored using the combination of the following search terms: sacroiliac joint, fusion, arthrodesis, and back pain. We used different combinations of the following queries: sacroiliac joint AND (fusion OR arthrodesis) and back pain. A primary search of databases yielded 420 records. After duplicates removal, 228 potentially eligible articles were identified. A total of 21 studies fulfilled the inclusion criteria and were included in the final systematic review. Results Assessments of outcome were done by pain score, Oswestry Disability Index, Majeed score, and SF-36 Physical (PCS) and Mental (MCS) component scores changes before operation and after operation. Visual analog scale score was used by nine studies with mean pre operation value of 7.3, which decreased after operation to 2.8, and regarding Oswestry Disability Index score, it used by 12 studies, with mean preoperative score of 40.45, which improved postoperatively to 22.89. Conclusion SIJ fusion appears to be a satisfactory procedure for alleviating low back pain.