Utilization of Minimally Invasive Surgical Approach for Sacroiliac Joint Fusion in Surgeon Population of ISASS and SMISS Membership

INTRODUCTION: The sacroiliac joint (SIJ) may be a source of chronic low back pain in 15 -22% of patients. Over the past four years MIS is an emerging standard of care for SI joint fusion. The International Society for the Advancement of Spine Surgery (ISASS) and Society for Minimally Invasive Spine Surgery (SMISS) conducted a survey of their members to examine current preferences in surgeon practice of MIS SI fusion. METHODS: To qualify for survey participation, the surgeon had to perform at least one open or MIS SIJ fusion procedure between 2009 and 2012. All surgeons were instructed to review their records. This included the number of surgical procedures performed annually from 2009-2012, site of service where each procedure was commonly performed, and average length of stay for each approach. RESULTS: Twenty four percent (121/500) of the eligible members participated in this survey. This survey revealed that the percentage of MIS procedures increased from 39% in 2009 to over 87% in 2012. The survey showed a significant increase in average number of MIS surgeries and a significant difference between open and MIS surgeries in 2012 (p<0.0001). In addition, 80% of the survey respondents indicated a lack of preference toward open approach if that was the only available option. CONCLUSIONS: According to performed survey, MIS SIJ fusion is preferred over open technique. Incorporation of the MIS technique into the spine surgeon's specter of skills would allow an increased number of surgical options as well as possible increase in outcome quality.