Clinical Efficacy and Safety of Minimally Invasive Sacroiliac Joint Fusion: A Retrospective Cohort Study

Background Sacroiliitis, inflammation of one or both sacroiliac (SI) joints, is a frequent yet often underrecognized source of chronic low back pain. Conservative treatments - such as physical therapy, medications, and corticosteroid injections - are the first-line treatment options for these patients. However, when they fail to provide lasting relief, surgery may become necessary. The purpose of this study is to evaluate the clinical outcomes of minimally invasive SI joint fusion (MI SIJF), specifically focusing on pain improvement and postoperative complication rates at the six-month follow-up. Methodology A retrospective chart review of 17 patients who underwent MI SIJF procedures was conducted. Two of the participants underwent bilateral SI fusions at separate time points, resulting in a total of 19 MI SIJF procedures in the cohort. Patient-reported outcomes, including pain scores via the visual analog scale (VAS), were collected at baseline, 10 days, six weeks, 10 weeks, and six months postoperatively. Complication rates and time to symptom relief were also recorded. Statistical analyses were performed using paired t-tests and linear mixed-effects modeling to assess changes in VAS pain scores across postoperative timepoints. A p-value of <0.05 was considered statistically significant. Analyses were performed using Microsoft Excel (Microsoft® Corp., Redmond, WA) and jamovi (Jonathon Love, Damian Dropmann, and Ravi Selker, Sydney, Australia). Results From the data collected, the average percent pain relief at six months post-SI fusion was 74.7%. The mean VAS pain score improved significantly from a baseline of 75.8 to 17.8 at six months. While initial symptom relief was noted as early as 10 days postoperatively, maximal improvement was realized by the six-month mark. No major complications were observed within the cohort. Conclusion This study suggests that MI SIJF is a safe and clinically effective treatment for patients with chronic sacroiliitis who have not achieved adequate relief through conservative management. The observation of significant pain reduction as early as 10 days postoperatively highlights a potential for early recovery that warrants further investigation. While further prospective controlled trials are necessary to validate these findings in larger populations, our results indicate that MI SIJF is a reliable intervention for achieving substantial symptomatic improvement in patients with chronic sacroiliitis.