Minimally Invasive SI Joint Fusion Improves Pain and Disability With Low Reoperation Rates: A Meta-Analysis of...

Area of Science:

• Orthopedics
• Spine Surgery
• Pain Management

Background:

• Low back pain is a leading cause of disability.
• Sacroiliac joint (SIJ) dysfunction is implicated in up to 25% of low back pain cases.
• Minimally invasive SIJ fusion offers a treatment option for refractory SIJ pain.

Purpose of the Study:

• To perform a meta-analysis of prospective studies on minimally invasive SIJ fusion.
• To evaluate changes in Visual Analogue Scale (VAS) pain scores and Oswestry Disability Index (ODI).
• To assess the rate of serious adverse events (SAE) requiring reoperation.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Inclusion of 11 studies (9 prospective cohort, 2 RCTs) with 1,181 SIJ fusions.
• Pooled analysis of VAS and ODI improvements and reoperation rates.

Main Results:

• Significant improvements in VAS (45.5 points) and ODI (23.3 points), exceeding minimal clinically important differences (MCID).
• Sacroiliac joint pathology confirmed by diagnostic injection in 92.7% of patients.
• A low reoperation rate of 3% for implant-related SAEs was observed.

Conclusions:

• Minimally invasive SIJ fusion provides substantial and reproducible improvements in pain and function.
• Rigorous patient selection and accurate SIJ dysfunction diagnosis are crucial for success.
• Standardized diagnostic pathways enhance surgical benefit and patient outcomes.