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Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?

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Abstract

Purpose

The purpose of this prospective case series (level II) was to determine the clinical outcomes of anterior SIJ fusion, comparing the outcomes of patients who had prior spinal fusions at any level compared to patients who have not.

Methods

This prospective study included 25 patients who underwent SIJ fusion with anterior plate fixation. All patients had failed non-operative treatment, had a positive Patrick test, and positive response to intra-articular SIJ injections with greater than 50 % pain relief. Patients had follow-up at 3, 6, 9 and 12 months where they completed Oswestry disability index (ODI) and Short Musculoskeletal Functional Assessment (SMFA) surveys. Outcome data are available for 19 patients who completed pre-operative and 12-month follow-up surveys. Their average time of the final follow-up was 1.1 years (range 10–33 months).

Results

Significant improvements between pre-operative and the final follow-up in ODI (p = 0.007) and SMFA (p = 0.01) were observed; the ODI assessed outcomes in patients who had previous spinal fusion surgery were significantly worse than those that did not at the final follow-up (p = 0.04).

Conclusion

Patients who have not undergone prior spinal fusion surgery, regardless of age, gender, and BMI have better outcomes following anterior SIJ fusion.

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References

  1. Fortin JD, Aprill CN, Ponthieux B, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part II: clinical evaluation. Spine 19:1483–1489

    Article  PubMed  CAS  Google Scholar 

  2. Fortin JD, Dwyer AP, West S, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part I: asymptomatic volunteers. Spine 19:1475–1482

    Article  PubMed  CAS  Google Scholar 

  3. Dreyfuss P, Michaelsen M, Pauza K, McLarty J, Bogduk N (1996) The value of medical history and physical examination in diagnosing sacroiliac joint pain. Spine 21:2594–2602

    Article  PubMed  CAS  Google Scholar 

  4. Bernard T, Cassidy J (1999) The sacroiliac joint syndrome: pathophysiology, diagnosis, and management. The adult spine: principles and practice, 2nd edn. Lippincott-Raven, Philadelphia, pp 2343–2366

    Google Scholar 

  5. Maigne JY, Planchon CA (2005) Sacroiliac joint pain after lumbar fusion. A study with anesthetic blocks. Eur Spine J 14:654–658

    Article  PubMed  CAS  Google Scholar 

  6. Schwarzer AC, Aprill CN, Bogduk N (1995) The sacroiliac joint in chronic low back pain. Spine 20:31–37

    Article  PubMed  CAS  Google Scholar 

  7. Ha KY, Lee JS, Kim KW (2008) Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up. Spine 33:1192–1198

    Article  PubMed  Google Scholar 

  8. Zelle BA, Gruen GS, Brown S, George S (2005) Sacroiliac joint dysfunction: evaluation and management. Clin J Pain 21:446–455

    Article  PubMed  Google Scholar 

  9. Schutz U, Grob D (2006) Poor outcome following bilateral sacroiliac joint fusion for degenerative sacroiliac joint syndrome. Acta Orthop Belg 72:296–308

    PubMed  Google Scholar 

  10. van der Wurff P, Meyne W, Hagmeijer RH (2000) Clinical tests of the sacroiliac joint. Man Ther 5:89–96

    Article  PubMed  Google Scholar 

  11. van der Wurff P, Hagmeijer RH, Meyne W (2000) Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: reliability. Man Ther 5:30–36

    Article  PubMed  Google Scholar 

  12. Freburger JK, Riddle DL (2001) Using published evidence to guide the examination of the sacroiliac joint region. Phys Ther 81:1135–1143

    PubMed  CAS  Google Scholar 

  13. Kokmeyer DJ, Van der Wurff P, Aufdemkampe G, Fickenscher TC (2002) The reliability of multitest regimens with sacroiliac pain provocation tests. J Manip Physiol Ther 25:42–48

    Article  Google Scholar 

  14. Laslett M, Young SB, Aprill CN, McDonald B (2003) Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust J Physiother 49:89–97

    PubMed  Google Scholar 

  15. Laslett M, Aprill CN, McDonald B (2006) Provocation sacroiliac joint tests have validity in the diagnosis of sacroiliac joint pain. Arch Phys Med Rehabil 87:874 (author reply 874–875)

    Article  PubMed  Google Scholar 

  16. Maigne JY, Aivaliklis A, Pfefer F (1996) Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine 21:1889–1892

    Article  PubMed  CAS  Google Scholar 

  17. Potter NA, Rothstein JM (1985) Intertester reliability for selected clinical tests of the sacroiliac joint. Phys Ther 65:1671–1675

    PubMed  CAS  Google Scholar 

  18. Riddle DL, Freburger JK (2002) Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: a multicenter intertester reliability study. Phys Ther 82:772–781

    PubMed  Google Scholar 

  19. Dreyfuss P, Dreyer SJ, Cole A, Mayo K (2004) Sacroiliac joint pain. J Am Acad Orthop Surg 12:255–265

    PubMed  Google Scholar 

  20. Fairbank JC, Pynsent PB (2000) The Oswestry disability index. Spine (Phila Pa 1976) 25:2940–2952 (discussion 2952)

    Article  CAS  Google Scholar 

  21. Hudson-Cook N, Tomes-Nicholson K, Breen A (1989) A revised Oswestry disability questionnaire. In: Roland M, Jenner J (eds) Back pain: new approaches to rehabilitation and education. Manchester University Press, Manchester, pp 187–204

    Google Scholar 

  22. Swiontkowski MF, Engelberg R, Martin DP, Agel J (1999) Short musculoskeletal function assessment questionnaire: validity, reliability and responsiveness. J Bone Joint Surg (Am) 81:1245–1260

    Article  CAS  Google Scholar 

  23. Laslett M, Aprill CN, McDonald B, Young SB (2005) Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 10:207–218

    Article  PubMed  Google Scholar 

  24. Belanger TA, Dall BE (2001) Sacroiliac arthrodesis using a posterior midline fascial splitting approach and pedicle screw instrumentation: a new technique. J Spinal Disord 14:118–124

    Article  PubMed  CAS  Google Scholar 

  25. Buchowski JM, Kebaish KM, Sinkov V, Cohen DB, Sieber AN, Kostuik JP (2005) Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint. Spine J 5:520–528 (discussion 529)

    Article  PubMed  Google Scholar 

  26. Waisbrod H, Krainick JU, Gerbershagen HU (1987) Sacroiliac joint arthrodesis for chronic lower back pain. Arch Orthop Trauma Surg 106:238–240

    Article  PubMed  CAS  Google Scholar 

  27. Daum WJ (1995) The sacroiliac joint: an underappreciated pain generator. Am J Orthop (Belle Mead NJ) 24:475–478

    CAS  Google Scholar 

  28. Simonian PT, Routt ML Jr, Harrington RM, Mayo KA, Tencer AF (1994) Biomechanical simulation of the anteroposterior compression injury of the pelvis. An understanding of instability and fixation. Clin Orthop Relat Res 309:245–256

    PubMed  Google Scholar 

  29. Leighton RK, Waddell JP (1996) Techniques for reduction and posterior fixation through the anterior approach. Clin Orthop Relat Res 329:115–120

    Article  PubMed  Google Scholar 

  30. Rand JA (1985) Anterior sacro-iliac arthrodesis for post-traumatic sacro-iliac arthritis. A case report. J Bone Joint Surg Am 67:157–159

    PubMed  CAS  Google Scholar 

  31. Simpson LA, Waddell JP, Leighton RK, Kellam JF, Tile M (1987) Anterior approach and stabilization of the disrupted sacroiliac joint. J Trauma 27:1332–1339

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Av., Suite R200, Minneapolis, MN, 55454, USA

    Nate Slinkard, Julie Agel & Marc F. Swiontkowski

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  1. Nate Slinkard
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  2. Julie Agel
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  3. Marc F. Swiontkowski
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Corresponding author

Correspondence to Julie Agel.

Appendix

Appendix

See Table 3.

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Slinkard, N., Agel, J. & Swiontkowski, M.F. Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?. Eur Spine J 22, 2318–2324 (2013). https://doi.org/10.1007/s00586-013-2968-1

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  • DOI: https://doi.org/10.1007/s00586-013-2968-1

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