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Research ArticleTesting & Regulatory Affairs

International Society for the Advancement of Spine Surgery Policy 2020 Update—Minimally Invasive Surgical Sacroiliac Joint Fusion (for Chronic Sacroiliac Joint Pain): Coverage Indications, Limitations, and Medical Necessity

MORGAN LORIO, RICHARD KUBE and ALI ARAGHI
International Journal of Spine Surgery December 2020, 14 (6) 860-895; DOI: https://doi.org/10.14444/7156
MORGAN LORIO
1Advanced Orthopedics, Altamonte Springs, Florida
MD, FACS
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RICHARD KUBE
2Prairie Spine & Pain Institute, Peoria, Illinois
MD
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ALI ARAGHI
3The CORE Institute, Sun City West, Arizona
DO
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  • Figure 1
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    Figure 1

    Baseline (blue) and last follow-up (green) visual analog scale or numeric rating scale sacroiliac joint (SIJ) pain scores in cohorts of patients treated with lateral transiliac (LTI) SIJ fusion (SIJF) or posterior SIJF. Horizontal bracketed bars denote confidence limit. Device type shown by shape. Kancherla is primarily titanium triangular implants but includes a small number of cases with a screw. CTI indicates cylindrical titanium implant.

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    Figure 2

    Change in visual analog scale or numeric rating scale sacroiliac joint pain score by study for devices placed by lateral transiliac (LTI) approach or posterior approach. Larger positive values mean more improvement. Device type shown by shape. Horizontal bracketed bars denote confidence limit. Note that Wise 2008 reported change scores but not population means at baseline and follow-up.

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    Figure 3

    Baseline (blue) and last follow-up (green) ODI scores in cohorts of patients treated with lateral transiliac (LTI) sacroiliac joint fusion (SIJF) or posterior SIJF. Two studies did not report baseline ODI scores. Device type shown by shape. Horizontal bars denote confidence limit.

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    Figure 4

    Change in Oswestry Disability Index by study for devices placed by lateral transiliac (LTI) procedure and posterior procedure. Larger positive values mean more improvement. Device type shown by shape. Horizontal bracketed bars denote confidence limit.

  • Figure A1
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    Figure A1

    Literature search exclusions flow chart. The flow chart excludes the following 8 articles; narrative, systematic reviews, and meta-analyses: Shamrock – Global Spine Journal – 2019: The safety profile of percutaneous minimally invasive sacroiliac joint fusion.191; Whelan – Techniques in Orthopaedics – 2019: The evidence for sacroiliac joint surgery.190; Tran – Pain Physician - 2019: Sacroiliac joint fusion methodology—minimally invasive compared to screw-type surgeries: a systematic review and meta analysis.188; Zaidi – J Neurosurg Spine 2015: Surgical and clinical efficacy of sacroiliac joint fusion: a systematic review of the literature.189; Heiney – Int J Spine Surg 2015: A systematic review of minimally invasive sacroiliac joint fusion utilizing a lateral transarticular technique.186; Lingutla – Eur Spine J 2016: Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis.187; Yson - PM R 2019: Sacroiliac joint fusion: approaches and recent outcomes. Published online.192; Martin – Int J Spine Surg. 2020: Minimally invasive sacroiliac joint fusion: the current evidence.193 Also excludes: Mao A - Orthop Rev (Pavia) 2018: A Consideration for the utility of the post-operative Oswestry Disability Index for measuring outcomes after sacroiliac joint fusion, as this article was simply an evaluation of ODI as an outcome measure.182

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International Journal of Spine Surgery
Vol. 14, Issue 6
1 Dec 2020
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International Society for the Advancement of Spine Surgery Policy 2020 Update—Minimally Invasive Surgical Sacroiliac Joint Fusion (for Chronic Sacroiliac Joint Pain): Coverage Indications, Limitations, and Medical Necessity
MORGAN LORIO, RICHARD KUBE, ALI ARAGHI
International Journal of Spine Surgery Dec 2020, 14 (6) 860-895; DOI: 10.14444/7156

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International Society for the Advancement of Spine Surgery Policy 2020 Update—Minimally Invasive Surgical Sacroiliac Joint Fusion (for Chronic Sacroiliac Joint Pain): Coverage Indications, Limitations, and Medical Necessity
MORGAN LORIO, RICHARD KUBE, ALI ARAGHI
International Journal of Spine Surgery Dec 2020, 14 (6) 860-895; DOI: 10.14444/7156
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  • Article
    • ABSTRACT
    • OVERVIEW OF SACROILIAC JOINT ANATOMY, PAIN ETIOLOGY AND EPIDEMIOLOGY, DIAGNOSIS, AND NONSURGICAL INTERVENTIONS
    • COVERAGE RATIONALE FOR OPEN AND MIS SIJ FUSION
    • LATERAL TRANSILIAC MIS PROCEDURES
    • POSTERIOR (DORSAL) MIS PROCEDURES
    • LITERATURE SEARCH
    • INDICATIONS AND LIMITATIONS OF COVERAGE
    • CODING
    • DOCUMENTATION REQUIREMENTS
    • SURGEON QUALIFICATIONS
    • COVERAGE/CONCLUSION
    • APPENDIX
    • Footnotes
    • REFERENCES
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Keywords

  • sacroiliac joint
  • minimally invasive surgery
  • pelvis
  • diagnosis

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