Minimally invasive sacroiliac joint fusion: one-year outcomes in 18 patients

BACKGROUND: Sacroiliac joint (SI) pain is an often-overlooked cause of low back pain due, in part, to lack of specific findings on radiographs and symptoms mimicking other back-related disorders. We report our experience with minimally invasive (MIS) SI joint arthrodesis using a series of triangular, titanium plasma spray (TPS) coated implants in patients refractory to conservative care. METHODS: We report outcomes from 18 patients with 12 months of postoperative follow-up. Demographics, complications, and clinical outcomes using visual analog scale (VAS) for pain, Oswestry Disability Index (ODI) for back function and SF-12 for quality of life were collected preoperatively and at 3, 6 and 12 months post-operatively. RESULTS: Mean age was 64 years and 67% of patients were female. There were no intraoperative complications and one explant at three months for malposition. All patient-reported outcomes showed both clinically and statistically significant improvement at 12 months (p < 0.001 for each of the following): VAS improved by 6.6 points, ODI scores improved by −37.5 points. One year SF-12 physical and mental component (PCS, MCS) scores approximated population normal scores for both physical and mental functioning. Patient satisfaction with outcomes was high at 95%; 89% said would have the same surgery again. CONCLUSIONS: MIS SI joint fusion using a series of triangular porous TPS coated titanium implants is a safe and effective procedure for patients with SI joint disorders who have failed conservative care.