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Research ArticleMinimally Invasive Surgery

Minimally Invasive Sacroiliac Fusion Revision: A Technique Guide

Daniel J. Cognetti and Anton Y. Jorgensen
International Journal of Spine Surgery April 2021, 15 (2) 274-279; DOI: https://doi.org/10.14444/8037
Daniel J. Cognetti
1Department of Orthopedics, Brooke Army Medical Center, Houston, Texas
MD
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Anton Y. Jorgensen
2Ortho San Antonio, San Antonio, Texas
MD
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    Figure 1

    Three modes of failure in index sacroiliac joint (SIJ) fusion necessitating revision. (A) Violation of foramina causing radiculopathy. (B) Implant loosening about sacral aspect of implant. (C) Implant spanning the ligamentous portion of the SIJ.

  • Figure 2
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    Figure 2

    (A) Lateral graphic of the sacroiliac joint showing the posterior/dorsal ligamentous portion of the joint and the anterior/ventral cartilaginous portion of the joint. (B) Oblique graphic highlighting the narrow ventral true cartilaginous portion of the joint that is the target for implant placement. Image courtesy of Visible Body.

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    Figure 3

    Removal of loose implant with tubular retractor, screw removal set, and osteotomes.

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    Figure 4

    Inlet (A), outlet (B), lateral (C) fluoroscopic views after navigation assisted placement of newly revised triangular implants with comparison to previously placed contralateral circular implants, highlighting the more ventral triangular implants. The ventral trajectory crosses the cartilaginous portion of the joint.

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    Figure 5

    Axial and coronal postoperative computed tomography scans localized over the revised cephalad (A), middle (B), and caudal (C) navigated triangular implants, with previously placed contralateral circular implants. Red arrows: old implant tracts.

  • Figure 6
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    Figure 6

    Computed tomography scan demonstrating interosseous bridging anterior to the implant across the cartilaginous portion of the sacroiliac joint.

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International Journal of Spine Surgery
Vol. 15, Issue 2
1 Apr 2021
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Minimally Invasive Sacroiliac Fusion Revision: A Technique Guide
Daniel J. Cognetti, Anton Y. Jorgensen
International Journal of Spine Surgery Apr 2021, 15 (2) 274-279; DOI: 10.14444/8037

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Minimally Invasive Sacroiliac Fusion Revision: A Technique Guide
Daniel J. Cognetti, Anton Y. Jorgensen
International Journal of Spine Surgery Apr 2021, 15 (2) 274-279; DOI: 10.14444/8037
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More in this TOC Section

  • Comparative Review of Lateral and Oblique Lumbar Interbody Fusion: Technique, Outcomes, and Complications
  • Key Considerations in Surgical Decision-Making on the Side of Approach for Lumbar Lateral Transpsoas Interbody Fusion Techniques
  • A Spine Surgeon’s Learning Curve With the Minimally Invasive L5 to S1 Lateral ALIF Surgical Approach: Perioperative Outcomes and Technical Considerations
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Keywords

  • sacroiliac joint fusion
  • revision
  • technique guide
  • minimally invasive
  • arthrodesis
  • SI
  • SIJ

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