Minimally Invasive Sacroiliac Joint Fusion vs Conservative Management in Patients With Sacroiliac Joint Dysfunction: A Systematic Review and Meta-Analysis

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Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart.
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Figure 2
Comparison between MISJF and CM for the outcome of VAS-pain after 6 mo; CI, confidence interval; CM, conservative management; MISJF, minimally invasive sacroiliac joint fusion; VAS, visual analog scale.
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Figure 3
Comparison between MISJF and CM for the outcome of ODI after 6 mo; CI, confidence interval; CM, conservative management; MISJF, minimally invasive sacroiliac joint fusion; ODI, Oswestry Disability Index.

Table 1

Study characteristics.

Study	Study Design	Minimally Invasive Sacroiliac Joint Fusion Group		Conservative Management Group		Follow-Up (mo)	Quality Assessment
Study	Study Design	Participants, n (% Women)	Age, y, mean (Range)	Participants, n (% Women)	Age, y, mean (Range)	Follow-Up (mo)	Level of Evidence	Overall risk of bias
Polly et al, 2016	Randomized controlled trial	102 (73.5%)	50.2 (25.6 to 71.7)	46 (60.9%)	53.8 (29.5 to 71.1)	24	1	Low
Dengler et al, 2019	Randomized controlled trial	52 (73.1%)	49.4 (27 to 70)	51 (72.5%)	46.7 (23 to 69)	24	1	Low
Vanaclocha et al, 2017	Retrospective comparative cohort	27 (70.4%)	48.0 (25 to 69)	110 (55.2%)	49.7 (24 to 70)	72	4	Moderate
Cher et al, 2016	Cost-effectiveness analysis	274	–	46	–	12	–	–

Table 2

Study results for mean (SD) VAS-pain score.

Study	VAS-Pain MISJF Group, mean (SD)			VAS-Pain CM Group, mean (SD)		VAS-Pain Improvement Comparison Between Groups^{^a}
Study	Preop	Postop(6 mo)	Postop(24 mo)	Preop	Postop(6 mo)	VAS-Pain Improvement Comparison Between Groups^{^a}
Polly et al, 2016	82.3 (11.9)	30.1 (29.4)	26.5 (29.8)	82.2 (9.9)	70.3 (25.9)	38.2 (P < 0.0001)
Dengler et al, 2019	77.7 (11.3)	34.4 (23.9)	31.8 (29.8)	73.0 (13.8)	67.8 (20.3)	34 (P < 0.0001)
Vanaclocha et al, 2017	7.8 (1.4)	2.4 (1.1)	1.6 (0.8)	7.5 (1.4)	7.2 (1.8)	6 (P < 0.001)

↵a VAS-pain improvement in the MISJF group compared to the CM group (combining timepoints).
CM; conservative management, MISJF, minimally invasive sacroiliac joint fusion; Postop, postoperative; Preop, preoperative; VAS-pain; visual analog scale for pain.

Table 3

Study results for mean (SD) ODI.

Study	ODI MISJF Group, mean (SD)			ODI CM Group, mean (SD)		ODI Improvement Comparison Between Groups
Study	Preop	Postop(6 mo)	Postop(24 mo)	Preop	Postop(6 mo)	ODI Improvement Comparison Between Groups
Polly et al, 2016	57.2 (12.8)	29.9 (20.5)	28.5 (21.9)	56.0 (14.0)	51.6 (18.8)	23.8 (P < 0.0001)
Dengler et al, 2019	57.5 (14.4)	32.0 (18.4)	30.2 (19.0)	55.6 (13.7)	50.2 (17.2)	18 (P < 0.0001)
Vanaclocha et al, 2017	41.7 (6.8)	25.2 (5.7)	18.4 (5.3)	38.3 (7.9)	38.9 (8.3)	24 (P < 0.001)

a ODI improvement in the MISJF group compared to the CM group (combining timepoints).
CM; conservative management, MISJF, minimally invasive sacroiliac joint fusion; ODI; Oswestry Disability Index; Postop, postoperative; Preop, preoperative.