Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence

Background Fusion of the sacroiliac (SI) joint as a treatment for low back pain remains controversial. The purpose of this manuscript is to review the current literature and clinical outcomes of SI joint fusion surgery.

Methods We conducted a literature review and included studies with the term “sacroiliac joint fusion” that had at least 12 months of clinical follow-up, reported on minimally invasive techniques, and included patient-reported outcome measures.

Results Two approach types (dorsal and lateral) and numerous different implant manufacturers were identified. Most studies included level 4 data, with a small number of level 2 prospective cohort studies and 2 prospective level 1 studies. Every reviewed study reported clinical benefit in terms of improved pain scores or improvement in validated disability measures. Complication rates were low.

Conclusions Minimally invasive SI joint fusion provides clinically significant improvement in pain scores and disability in most patients, across multiple studies and implant manufacturers.

Level of Evidence 5

Clinical Relevance Emerging evidence in support of SI joint fusion indicates that clinicians should examine the SI joint and include SI joint pain in their differential diagnosis for low back pain patients.