ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion

Morgan P. Lorio; Ralph Rashbaum

doi:10.14444/1025

Article Figures & Data

Tables

View popup

Table 1

Author, Year	N	Study design	Demographics	Implantdescription	Results	Complications
Rudolf, 2012	50	Retrospectivecase series	Age: 54 years Sex: 34F/16M Prior lumbar fusion: 44% Follow up:40mo (range24-56)	iFuse ImplantSystem	VAS: 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, 2013	40	Retrospectivecase series	Age: 58 years Sex: 30F/10M Prior lumbar fusion: 30% Follow up: 12months	iFuse ImplantSystem	VAS: 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,2013	18	Retrospectivecase series	Age: 64 years Sex: 12F/6M Prior lumbar fusion: 61% Follow up:12mo	iFuse ImplantSystem	VAS: 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, 2013	12	Retrospectivecase series	Age: 53 years Sex: 12F Prior lumbar fusion: 1 Follow up:10mo	iFuse ImplantSystem	VAS: 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, 2013	6	Retrospectivecase series	Age: 50 years Sex: 6F/0M Prior lumbar fusion: 100% (deformitycorrection) Follow up:10mo	iFuse ImplantSystem	VAS: 7.8 pre-op,2.7 at f/u ODI: 44.2 pre-op,21 f/u	None reported
Graham-Smith, 2013	114	Retrospectivemulticenter, comparativecohort study	Age: 57 years Sex: 82F/32M Prior lumbar fusion: 47% Follow up: 24 mo	iFuse ImplantSystem	VAS: 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, 2013	32, 94	Prospective,multi-center	Age: 50 years Sex: 21F/11M Prior lumbar fusion: 69% Follow-up: 6months	iFuse ImplantSystem	VAS: 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, 2014	144	Retrospective,multi-center	Age: 58 years Sex: 30F/10M Prior lumbar fusion: 62% Follow-up:16mo	iFuse ImplantSystem	VAS: 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 2008	9	Retrospectivecase series	Age: 42 years Sex: 9F Follow-up: 40 mo	Hollow modular anchorage screwpacked withdemineralized bone matrix	VAS 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, 2009	15	Retrospectivecase series	Age: 48.7 years Sex: 11F/4M Prior lumbar fusion: 40% Follow-up: 17months	Hollow modular anchorage screwpacked withdemineralized bone matrix	SF-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, 2013	55	Retrospectivecase series	Age: 57 years Sex: 46F/9M Prior lumbar fusion: 40% Follow up:36mo	Hollow modular anchorage screwpacked withdemineralized bone matrix	VAS: 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, 2008	13	Retrospectivecase series	Age: 53 years Sex: 12F/1M Prior lumbar fusion: 8/13 Follow-up:29.5mo	2 Titanium cages packed with BMP	VAS 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, 2012	37	Retrospectivecase series	Age: 42.5 years Sex: 34F/3M Follow up:40mo	Fibular allograftdowels	Baseline VAS: 9.1 Final VAS: 3.4	Nonunion requiring revision: 4 (10.5%)
Giannikas, 2004	5	Retrospectivecase series	Age: 30.6 years Sex: 3F/2M Follow up:29mo	Autograft iliacbone plugs	Complete painrelief: 4/5 Partial pain relief: 1/5 *Patient kept nonweight bearing for atleast 3 months	None reported

View popup

Table 2

ICD-9 code	Description
720.2	Sacroiliitis not elsewhere classified; inflammation of sacroiliac joint NOS
721.3	Lumbosacral spondylosis without myelopathy
724.6	Disorders of sacrum
739.4	Nonallopathic lesions, not elsewhere classified in the sacral region; sacrococcygeal region or sacroiliac region
846.9	Sprains and strains of the sacroiliac region, unspecified site of sacroiliac region
847.3	Sprains and strains of sacrum