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Research ArticleArticles

A systematic review of minimally invasive sacroiliac joint fusion utilizing a lateral transarticular technique

Jake Heiney, Robyn Capobianco and Daniel Cher
International Journal of Spine Surgery January 2015, 9 40; DOI: https://doi.org/10.14444/2040
Jake Heiney
1University of Toledo Medical Center, Toledo, Ohio
MD
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Robyn Capobianco
2SI-BONE, Inc., San Jose, California
MA
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Daniel Cher
2SI-BONE, Inc., San Jose, California
MD
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Abstract

Background A number of studies have been published regarding minimally invasive surgical (MIS) fusion of the sacroiliac (SI) joint using a lateral transarticular approach. Herein we report a systematic review and meta-analysis to summarize operative measures and clinical outcomes reported in published studies of MIS SI joint fusion.

Methods The systematic review was done according to PRISMA standards. PubMed and EMBASE were searched using the terms sacroiliac joint AND fusion. Original peer-reviewed articles in the English language that reported clinical outcomes on at least 5 cases of MIS SI joint fusion using a lateral transarticular approach were included. Random effects meta-analysis (RMA) was performed on selected variables using the DerSimonian and Laird method, including operative measures, VAS SI joint pain ratings (0-10 scale) and Oswestry Disability Index (ODI). Mean and 95% confidence intervals (CI) were calculated and heterogeneity was assessed. Other findings were summarized qualitatively.

Results A total of 18 articles met the inclusion criteria. After accounting for overlapping cohorts, 12 unique cohorts from 4 countries were extracted for a total of 432 subjects. The RMA mean (range) was 59 minutes (27-78) for procedure time, 36.9cc (10-70) for estimated blood loss and 1.7 days (range 0-7) for length of stay (LOS). The RMA mean [95% CI] pain score dropped by 5.2 points at 6 months and 5.3 points at 12 months (baseline score of 8.1 [7.8-8.4], 12-month score of 2.7 [2.1-3.3]), and a 24-month score of 2.0(1.4-2.5). ODI decreased by 31 points at 12 months (baseline score of 56.2 [51.0-61.5], 6-month score of 30.7 [21.8-39.6], and 12-month score of 25.1 [12.3-37.9]). Some estimates showed significant variation across studies and between the types of implants used. Other reported outcomes were supportive of the positive effects of SI joint fusion.

Conclusion Published studies of MIS SI joint fusion using a lateral transarticular approach confirm its minimally invasive characteristics with minimal blood loss and short operating room times, and show consistent, rapid, sustained and clinically important improvements in patient reported SI joint pain, disability and quality of life scores.

  • Minimally invasive surgery
  • degenerative sacroiliitis
  • sacroiliac joint disruption
  • sacroiliac joint dysfunction
  • sacroiliac joint fusion
  • meta-analysis
  • systematic review
  • Copyright © 2015 ISASS - This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery
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International Journal of Spine Surgery
Vol. 9
1 Jan 2015
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A systematic review of minimally invasive sacroiliac joint fusion utilizing a lateral transarticular technique
Jake Heiney, Robyn Capobianco, Daniel Cher
International Journal of Spine Surgery Jan 2015, 9 40; DOI: 10.14444/2040

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A systematic review of minimally invasive sacroiliac joint fusion utilizing a lateral transarticular technique
Jake Heiney, Robyn Capobianco, Daniel Cher
International Journal of Spine Surgery Jan 2015, 9 40; DOI: 10.14444/2040
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Keywords

  • minimally invasive surgery
  • degenerative sacroiliitis
  • sacroiliac joint disruption
  • sacroiliac joint dysfunction
  • sacroiliac joint fusion
  • meta-analysis
  • systematic review

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