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Pelvic joint fusions in patients with chronic pelvic girdle pain: a 23-year follow-up

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Abstract

Purpose

Fusion of the sacroiliac joints (SIJ) has been a treatment option for patients with severe pelvic girdle pain (PGP). The primary aims were to evaluate the long-term outcomes in patients who underwent SIJ fusion and to compare 1-year outcomes with long-term outcomes. The secondary aim was to compare patients who underwent SIJ fusion with a comparable group who did not.

Methods

This study includes fifty patients that underwent SIJ fusion between 1977 and 1998. Function (the Oswestry disability index; ODI), pain intensity (visual analogue scale; VAS) and health-related quality of life (SF-36) were determined according to a patient-reported questionnaire. The questionnaire scores were compared with previously recorded 1-year outcomes and with questionnaire scores from a group of 28 patients who did not undergo SIJ fusion.

Results

The patients who underwent SIJ fusion reported a mean ODI of 33 (95 % CI 24–42) and a mean VAS score of 54 (95 % CI 46–63) 23 years (range 19–34) after surgery. Regarding quality of life, the patients reported reduced physical function, but mental health was not affected in the same manner. The patients with successful 1-year outcomes (48 %) retained significantly improved function and reduced pain levels compared with the subgroup of patients with unsuccessful 1-year outcomes (28 %). The patients who underwent surgery did not differ from the non-surgery group in any outcome at the long-term follow-up.

Conclusions

Patients treated with SIJ fusion had moderate disability and pain 23 years after surgery, and the 1-year outcomes were sustained 23 years after surgery. Although many fused patients reported good outcome, this group did not differ from the comparable non-surgical group.

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Acknowledgments

We gratefully acknowledge the assistance of Ingar Holme for his help with statistics, Kaja Sætre (study coordinator) and Terje Sande with the DOS patient database. This study was supported by grants from the Norwegian Foundation for Health and Rehabilitation and Sophies Minde Ortopedi AS.

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Correspondence to Thomas J. Kibsgård.

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Kibsgård, T.J., Røise, O., Sudmann, E. et al. Pelvic joint fusions in patients with chronic pelvic girdle pain: a 23-year follow-up. Eur Spine J 22, 871–877 (2013). https://doi.org/10.1007/s00586-012-2512-8

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  • DOI: https://doi.org/10.1007/s00586-012-2512-8

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