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Sacroiliac joint fusion with triangular titanium implants results in significant improvement of pain and disability
EANS Academy. Kostadinov S. 09/26/19; 276085; EP02055
Stefan Kostadinov
Stefan Kostadinov

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Abstract
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Background: Sacroiliac joint (SIJ) dysfunction is an underdiagnosed condition. Several published cohorts have reported favorable outcomes after percutaneous SIJ fusion using titanium implants. We present here the 12-month follow-up of a large retrospective cohort of patients after SIJ fusion in a standard clinic setting.
Methods: A carefully selected group of 160 consecutive patients with painful SIJ dysfunction were diagnosed by standard methods, including SIJ infiltrations, and underwent unilateral or staged bilateral SIJ fusion using triangular titanium implants. Patients were seen for follow-up every 3 months and completed visual analog scale (VAS, 0-10 range) pain ratings and Oswestry Disability Index (ODI). Follow up CT scans were performed at 1 year.
Results: Mean patient age was 58 years, 68% were women. A total of 30% underwent staged bilateral SIJ fusion. By month 12, SIJ pain scores decreased from 8.0 to 2.5 (p < 0.0001) and disability (ODI) decreased from 45.3 to 16.4 (p < 0.0001). The proportion of patients with clinically significant improvements in SIJ pain and ODI was high (> 95%). Perioperative adverse events were minor and temporary. Subgroup analysis showed slightly smaller improvements in those undergoing bilateral surgery and those with a spinal cord stimulator in place. CT scan at 1 year showed reabsorption along one or more implants in 16% of cases, but there were no breakages, implant loosenings or removals.
Conclusions: In a standard clinical practice, SIJ fusion with triangular titanium implants produces significant improvement in pain and disability related to SIJ dysfunction.
Background: Sacroiliac joint (SIJ) dysfunction is an underdiagnosed condition. Several published cohorts have reported favorable outcomes after percutaneous SIJ fusion using titanium implants. We present here the 12-month follow-up of a large retrospective cohort of patients after SIJ fusion in a standard clinic setting.
Methods: A carefully selected group of 160 consecutive patients with painful SIJ dysfunction were diagnosed by standard methods, including SIJ infiltrations, and underwent unilateral or staged bilateral SIJ fusion using triangular titanium implants. Patients were seen for follow-up every 3 months and completed visual analog scale (VAS, 0-10 range) pain ratings and Oswestry Disability Index (ODI). Follow up CT scans were performed at 1 year.
Results: Mean patient age was 58 years, 68% were women. A total of 30% underwent staged bilateral SIJ fusion. By month 12, SIJ pain scores decreased from 8.0 to 2.5 (p < 0.0001) and disability (ODI) decreased from 45.3 to 16.4 (p < 0.0001). The proportion of patients with clinically significant improvements in SIJ pain and ODI was high (> 95%). Perioperative adverse events were minor and temporary. Subgroup analysis showed slightly smaller improvements in those undergoing bilateral surgery and those with a spinal cord stimulator in place. CT scan at 1 year showed reabsorption along one or more implants in 16% of cases, but there were no breakages, implant loosenings or removals.
Conclusions: In a standard clinical practice, SIJ fusion with triangular titanium implants produces significant improvement in pain and disability related to SIJ dysfunction.
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