The Influence of Lumbar and Lumbosacral Segmental Fusion as a Predictor of Sacroiliac Joint Pain

Objective: To evaluate the influence of lumbar and lumbo-sacral spinal fusion surgery on the incidence of postoperative sacroiliac joint (SIJ) pain. Methods: A retrospective analysis was conducted on 154 patients who underwent lumbar or lumbo-sacral spinal fusion between 2015 and 2019 at EMMS Nazareth Hospital, Israel. Clinical data, surgical details, and demographic factors were collected. Postoperative SIJ pain was diagnosed primarily through the FABER test and confirmed by selective injections and imaging when clinically indicated. Statistical analyses included Chi-square and Student's t-tests. Results: Postoperative SIJ pain was observed in 28.5% of patients. The incidence significantly correlated with the number of fused segments (p = 0.048) and the involvement of sacral segments (36.1% with sacral involvement vs. 16.7% without; p = 0.009). Demographic factors (age, gender, ethnicity) were not significant predictors. Conclusions: Lumbar and lumbo-sacral spinal fusions substantially increase the risk of postoperative SIJ pain, particularly with multi-segment and sacral-involved surgeries. Careful preoperative surgical planning is essential to minimize SIJ-related complications and improve patient outcomes.