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Published on: August 6, 2019
Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs
David W Polly1, Daniel J Cher, Kathryn D Wine
1*Departments of Orthopedic Surgery and Neurosurgery, University of Minnesota, Minneapolis, Minnesota; ‡SI-BONE, Inc, San Jose, California; §Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut; ¶Integrated Spine Care, Wauwatosa, Wisconsin; ‖Riverside Hospital, Kankakee, Illinois; #Bluegrass Orthopedics and Hand Care, Lexington, Kentucky; **Medical University of South Carolina, Charleston, South Carolina; ‡‡Aurora BayCare Orthopedic and Sports Medicine Center, Green Bay, Wisconsin; §§Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota.
Minimally invasive sacroiliac joint (SIJ) fusion offers superior pain relief and improved function for chronic SIJ dysfunction compared to nonsurgical options. Patients undergoing fusion experienced sustained benefits at one year, with crossover patients showing similar positive outcomes.
Area of Science:
- Orthopedics
- Spine Surgery
- Pain Management
Background:
- Sacroiliac joint (SIJ) dysfunction is a common source of persistent lower back pain.
- Effective treatment options for SIJ dysfunction are crucial for improving patient outcomes.
Purpose of the Study:
- To compare the effectiveness of minimally invasive SIJ fusion versus nonsurgical management for chronic SIJ dysfunction.
- To evaluate pain, disability, and quality of life outcomes in patients undergoing different treatment modalities.
Main Methods:
- A randomized controlled trial involving 148 subjects with SIJ dysfunction.
- Patients were assigned to either minimally invasive SIJ fusion with titanium implants or nonsurgical management.
- Outcomes including pain, disability, and quality of life were assessed at multiple time points up to 12 months.
Main Results:
- Minimally invasive SIJ fusion demonstrated significantly higher success rates at 6 months (81.4% vs 26.1%) compared to nonsurgical management.
- A substantial proportion of the surgical group achieved clinically important improvements in Oswestry Disability Index at 6 months (73.3% vs 13.6%).
- Improvements in pain and disability were sustained at 12 months in the surgical group, with similar benefits observed in patients who crossed over from nonsurgical care.
Conclusions:
- Minimally invasive SIJ fusion using triangular titanium implants is a highly effective treatment for chronic SIJ dysfunction.
- Surgical intervention provides superior and sustained relief from pain and disability compared to nonsurgical management.
- Nonsurgical patients who transitioned to surgery also experienced significant improvements in pain, function, and quality of life.
