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Research ArticleArticle
Open Access

ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion

Morgan P. Lorio and Ralph Rashbaum
International Journal of Spine Surgery January 2014, 8 25; DOI: https://doi.org/10.14444/1025
Morgan P. Lorio
1Neuro-Spine Solutions, Bristol, TN
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Ralph Rashbaum
2Texas Back Institute, Plano, TX
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    Table 1
    Author, YearNStudy designDemographicsImplantdescriptionResultsComplications
    Rudolf, 201250Retrospectivecase seriesAge: 54 years
    Sex: 34F/16M
    Prior lumbar fusion: 44%
    Follow up:40mo (range24-56)
    iFuse ImplantSystemVAS: 7.6 pre-op,2.0 at f/u
    Mean VAS improvement: -4.3 pts
    82% reached MCID
    82% patientsatisfaction
    OR time: 65 ± 26min
    Superficial cellulitis: 3
    Deep wound infection:1
    Hematoma: 2
    Reoperation: 3
    Sachs, 201340Retrospectivecase seriesAge: 58 years
    Sex: 30F/10M
    Prior lumbar fusion: 30%
    Follow up: 12months
    iFuse ImplantSystemVAS: 8.7 pre-op,0.9 at f/u
    Mean VAS improvement:-7.8pts
    98% reached MCID
    100% patientsatisfaction
    Piriformis syndrome: 1
    New LBP: 1
    Facet joint pain: 8
    Trochanteric bursitis: 2
    Cummings,201318Retrospectivecase seriesAge: 64 years
    Sex: 12F/6M
    Prior lumbar fusion: 61%
    Follow up:12mo
    iFuse ImplantSystemVAS: 9.0 pre-op,2.3 at f/u
    90% reached MCID
    Mean improvement:
    VAS -6.6pts,
    ODI -37.5pts,
    SF-12PCS 11.2,
    SF-12MCS 20.4
    94% very orsomewhat satisfied
    Trochanteric bursitis: 3
    Hematoma: 1
    Fluid retention:1
    Toe numbness: 1
    Implant malposition: 1
    Gaetani, 201312Retrospectivecase seriesAge: 53 years
    Sex: 12F
    Prior lumbar fusion: 1
    Follow up:10mo
    iFuse ImplantSystemVAS: 7.7 pre-op,3.0 f/u
    ODI: 31.4 pre-op,12.0 f/u
    100% patientsatisfaction
    3mth CT scans show initial fusion
    OR time: 65min
    EBL: <45cc
    2 local hematoma
    Schroeder, 20136Retrospectivecase seriesAge: 50 years
    Sex: 6F/0M
    Prior lumbar fusion: 100% (deformitycorrection)
    Follow up:10mo
    iFuse ImplantSystemVAS: 7.8 pre-op,2.7 at f/u
    ODI: 44.2 pre-op,21 f/u
    None reported
    Graham-Smith, 2013114Retrospectivemulticenter, comparativecohort studyAge: 57 years
    Sex: 82F/32M
    Prior lumbar fusion: 47%
    Follow up: 24 mo
    iFuse ImplantSystemVAS: 8.3 pre-op,2.3 at 12mo,
    1.7 at 24mo 86% reached MCID at 12mo,
    82% at 24mo OR time: 70min
    EBL: 33cc
    Hospital stay: 1.3days
    3.5% reoperation due to nerve rootimpingement, facet pain (4), fall (4),piriformis syndrome (2), cellulitis (3),trochanteric bursitis (2)
    Duhon, 201332, 94Prospective,multi-centerAge: 50 years
    Sex: 21F/11M
    Prior lumbar fusion: 69%
    Follow-up: 6months
    iFuse ImplantSystemVAS: 76.2 pre-op,29.3 f/u
    ODI: 55.3 pre-op,38.9 f/u
    SF-36PCS: 30.7 pre-op, 37 f/u
    88.5% success rate
    85% somewhat or very satisfied,
    OR time: 48min
    EBL: 59cc
    Hospital stay: 0.8days
    No implant revision or removal, 6 AEsprobably or definitely related to studyprocedure (1 nausea, 2 woundinfections, 1 cellulitis, 1 buttock pain)
    Sachs, 2014144Retrospective,multi-centerAge: 58 years
    Sex: 30F/10M
    Prior lumbar fusion: 62%
    Follow-up:16mo
    iFuse ImplantSystemVAS: 8.6 pre-op,2.7 f/u
    91% Very orsomewhat satisfied
    91.7% would have surgery again
    OR time: 73min
    EBL: minimal
    Hospital stay: 0.8days
    Implant revision (1), fall (5),trochanteric bursitis (4), piriformissyndrome (3), facet pain (3)
    Al-Khayer 20089Retrospectivecase seriesAge: 42 years
    Sex: 9F
    Follow-up: 40 mo
    Hollow modular anchorage screwpacked withdemineralized bone matrixVAS decreased: 8.1 to 4.6
    ODI decreased: 59 to 45
    Satisfaction: 6.8 (outof 10)
    Blood loss: <50 ml
    Hospital stay: 6.9days
    Return to work: 4/9
    1 deep wound infection Complication rate: 11%
    Khurana, 200915Retrospectivecase seriesAge: 48.7 years
    Sex: 11F/4M
    Prior lumbar fusion: 40%
    Follow-up: 17months
    Hollow modular anchorage screwpacked withdemineralized bone matrixSF-36 PF: 37 pre-op, 80 f/u
    Majeed's: 37 pre-op,79 f/u
    Good to excellent results: 13/15
    Blood loss: < 50 ml
    Hospital stay: 2.7days
    None reported
    Mason, 201355Retrospectivecase seriesAge: 57 years
    Sex: 46F/9M
    Prior lumbar fusion: 40%
    Follow up:36mo
    Hollow modular anchorage screwpacked withdemineralized bone matrixVAS: 8.1 pre-op,4.5 f/u
    SF-36, PCS: 26.6 pre-op, 43 f/u
    Majeed scoring:36.9 pre-op, 64.8 f/u
    2 cases of post-op nerve pain requiringreoperation
    Wise, 200813Retrospectivecase seriesAge: 53 years
    Sex: 12F/1M
    Prior lumbar fusion: 8/13
    Follow-up:29.5mo
    2 Titanium cages packed with BMPVAS improved by4.9 pts
    Leg VAS improvedby 2.4 pts
    Blood loss: < 100 ml
    Hospital stay: 1.7days
    Reoperation (nonunion): 1 Complication and Revision rate: 8%
    McGuire, 201237Retrospectivecase seriesAge: 42.5 years
    Sex: 34F/3M
    Follow up:40mo
    Fibular allograftdowelsBaseline VAS: 9.1
    Final VAS: 3.4
    Nonunion requiring revision: 4 (10.5%)
    Giannikas, 20045Retrospectivecase seriesAge: 30.6 years
    Sex: 3F/2M
    Follow up:29mo
    Autograft iliacbone plugsComplete painrelief: 4/5
    Partial pain relief: 1/5
    *Patient kept nonweight bearing for atleast 3 months
    None reported
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    Table 2
    ICD-9 codeDescription
    720.2Sacroiliitis not elsewhere classified; inflammation of sacroiliac joint NOS
    721.3Lumbosacral spondylosis without myelopathy
    724.6Disorders of sacrum
    739.4Nonallopathic lesions, not elsewhere classified in the sacral region; sacrococcygeal region or sacroiliac region
    846.9Sprains and strains of the sacroiliac region, unspecified site of sacroiliac region
    847.3Sprains and strains of sacrum
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1 Jan 2014
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ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion
Morgan P. Lorio, Ralph Rashbaum
International Journal of Spine Surgery Jan 2014, 8 25; DOI: 10.14444/1025

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ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion
Morgan P. Lorio, Ralph Rashbaum
International Journal of Spine Surgery Jan 2014, 8 25; DOI: 10.14444/1025
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  • Article
    • Background
    • Diagnosing the sacroiliac joint
    • Non-surgical treatment
    • Open and Minimally Invasive SI joint Fusion
    • Indications for surgery
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    • Conclusion
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