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Table 7 Reports of SI joint fusion

From: Open versus minimally invasive sacroiliac joint fusion: a multi-center comparison of perioperative measures and clinical outcomes

Author, Year N Demographics Diagnostic Standard Surgical Procedure/Post-op care Results Complications
Rudolf, 2012 [27] 50 Age: 54 3 or more positive iFuse Implant System OR time: 65 +/- 26 min Superficial cellulitis: 3
Gender: 34 F/16 M provocative maneuvers, confirmatory joint   Mean improvement on VAS: -4.3 pts at 12 months Deep wound infection:1
Prior lumbar fusion: 44% injections   Satisfaction 82% at 12 months Hematoma: 2
Reoperation: 3
Sachs, 2013 [26] 40 Age: 58 3 or more positive provocative maneuvers, confirmatory joint injections iFuse Implant System Mean improvement on VAS of -7.8 pts (p < 0.001) Piriformis syndrome:1
Gender: 30 F/10 M Patient satisfaction: New LBP:1
Follow up: 12 months Facet joint pain: 8
Prior lumbar fusion: 30% Trochanteric bursitis: 2
Cummings, 2013 [29] 18 Age: 64 3 or more positive provocative maneuvers, confirmatory joint injections iFuse Implant System Mean improvement in clinical outcomes: Trochanteric bursitis 3
Gender: 12 F/6 M VAS -6.6pts, Hematoma 1
Prior lumbar fusion: 61% ODI -37.5pts, Fluid retention
SF-12PCS 11.2, 1
SF-12 MCS 20.4 Toe numbness 1
Satisfaction: implant malposition 1
Very 55.6%, Somewhat 39%.  
Would have surgery again: yes 83%, likely 6%
Kibsgard, 2012 [34] 50, 28 Fusion (50 pts) PSIS tenderness, positive straight leg raise, positive provocative maneuvers Trans-iliac fusion or intra/extra-articular fusion between the ilium and the sacrum using cortical iliac window and iliac crest autograft. Surgical patients after 1 year: 24 (48%) patients were good, 12 (24%) were fair, and 14 (28%) were poor. Reoperation: 7
Age: 58 Post-op care: In most cases the patients were confined to 6 weeks of bed rest. No significant difference in ODI, VAS, or SF-36 between surgery and non-surgery patients after long-term follow-up. Nonunion: 8
Gender: 47 F/3 M Jaundice: 1
Follow-up: 23 yrs Pulmonary embolism: 1
Unilateral 21/Bilateral 25 Pin tract infection: 1
Dx: Post-partum (30), Trauma (8), Idiopathic (12) Complication rate: 20%
Non-Surgery (28 pts)   Revision rate: 14%
Age: 52
Gender: 28 F
Follow-up: 17 yrs
Khurana, 2009 [22] 15 Age: 48.7 years Tenderness over the posterior SI joint, positive provocative maneuvers, pain relief with SI joint block 10 mm Hollow Modular Anchorage Screw packed with demineralized bone matrix across the SI joint. Blood loss: < 50 ml None reported
Gender 11 F/4 M Post-op care: Partial weight bearing for six weeks and full weight bearing by 12 weeks. LOS 2.7 days
Follow-up: 17 months SF-36 increased: PF 37 to 80, GH 53 to 86
Unilateral 11/Bilateral 4 Majeed's: 37 to 79
Previous lumbar surgery: 40% Good/Excellent: 13/15
Dx: Osteoarthritis (7), SI joint dysfunction(4), SI joint instability (3), Inflammatory Arthritis (1) Fusion in all patients
Al-Khayer2008 [23] 9 Age: 42 years Tenderness over the sacral sulcus, positive provocative maneuvers, 10 mm Hollow Modular Anchorage Screw packed with demineralized bone matrix across the SI joint. Blood loss: <50 ml 1 deep wound infection
Gender: 9 F X-rays to exclude other pain sources, relief from SI joint block Post-op care: early mobilization w/in pain limits No screw loosening, nonunion, or failure Complication rate: 11%
Follow-up: 40 mo LOS: 6.9 days
Unilateral 6 /Bilateral 3 Return to work: 4/9
Symptom Duration: 30 mo ODI decreased: 59 to 45
Prior treatments: Failed conservative treatment VAS decreased: 8.1 to 4.6
Dx: Chronic SI joint pain Satisfaction: 6.8 (out of 10)
Wise, 2008 [24] 13 Age: 53 years Relief with SI joint block 9 mm hole drilled through the longitudinal aspect of the SI joint. 2 cages packed with BMP placed across the anterior portion of the SI joint. Blood loss: < 100 ml Reoperation (nonunion): 1
Gender: 12 F/1 M Post-op care: limited waist bending, and a sacral belt for 6 mo; full activity at 6 mo Length of stay: 1.7 days Complication and Revision rate: 8%
Follow-up: 29.5 mo Fusion rate: 89%
Unilateral 7/Bilateral 6 Low back VAS improved 4.9 pts
Previous lumbosacral surgery: 8/13 Leg VAS improved 2.4 pts
Prior treatments: Failed > 6 mo of conservative therapy
Buchowski, 2005 [21] 20 Age: 45 years Sacral sulcus palpation, Modified Smith-Petersen Blood loss: 290 mL Pseudoarthrosis: 3
Gender: 17 F/3 M positive provocative maneuvers, Incision over posterior 2/3 of iliac crests. Graft stabilized w/ plate and screws. Solid fusion: 17 Deep wound infection: 2
Follow-up: 5.8 yrs Pain relief with intraarticular SI joint injections Post-op care: Non-weight bearing for at least 3 months. LOS: 5.2 days Painful hardware: 1
Prior treatments: All failed nonoperative treatment Return to work: 8/20 Revision surgery (anterior): 3
Previous spine surgery: 15/20 SF-36 improved (except GH & MH) Complication rate: 30%
Symptom Duration: 2.6 yrs AAOS MODEMS sig. improved (except Comorbidity) Revision rate: 15%
Dx: SI joint dysfunction (13), Osteoarthritis (5), Spondyloarthropathy (1), SI joint instability (1) 60% would have surgery again  
Giannikas, 2004 [35] 5 Age: 22 to 44 years SI joint tenderness, positive provocative maneuvers, bone scan, relief with SI joint block Two bone plugs harvested from the iliac crest and placed through the superior and inferior aspects of the SI Joint. Complete pain relief: 4/5 None reported
Gender: 3 F/2 M   Post-op care: Non-weight bearing for at least 3 months. Partial pain relief: 1/5
Follow-up: 29 mo
Symptom Duration: 10 to 40 mo
Dx: Idiopathic (1), Previous trauma (4)
Moore, 1997 [20] 77 Gender: 48 F/29 M Relief with SI joint block Modified Smith-Petersen technique with 15 cm incision to reveal the ilium and sacrum. Bone harvested from the ilium and placed in the SI joint after removing the cartilage. 2–3 cannulated screws to lock graft in place. 62/77 successful (80.5%) Superficial wound infection: 1
Unilateral 74/Bilateral 3 Post-op care: Non-weight bearing for 8 weeks. Post-op radicular pain: 1
Prior treatments: Failed 6 months of rehab programs Sciatic notch fracture: 1
Symptom duration: 6 to 84 mo Pseudoarthrosis: 7
Follow-up: 1 to 5 years Complication rate: 13%
Dx: Chronic painful dysfunction
Keating, 1995 [19] 26 Age: 38.3 years Relief with SI joint block Inferior SI joint debrided, decorticated, and packed with bone graft. Secured with 2 lateral compression screws. Pain decreased: 6.1 to 2.9 None reported
Follow-up: 16 weeks Post-op care: 16 week rehabilitation program. Work Status increased: 2.3 to 3.3
Prior treatments: Failed 6 weeks of aggressive rehab 5 patients returned to work after 16 mo of unemployment
Symptom duration: 38.3 mo
Dx: Chronic LBP
Waisbrod, 1987 [17] 21 Age: 42 Tenderness over the SI joint, positive provocative maneuvers, pain provocation w/ NaCL injection, relief w/ SI joint block SI joint excised and packed w/ iliac crest bone graft and ceramic blocks. 11/21 Satisfactory results Pseudoarthrosis: 2
Gender: 18 F/3 M Post-op care: Spica cast for 8 weeks. Infection: 1
Follow-up: 30 mo Complication rate: 14%
Previous spine surgery: 7/21
Symptom duration: > 2 years
Dx: SI joint pain