Introduction: The SI joint has long been an underappreciated source of low back pain, due in part primarily to the difficulty in establishing a clear diagnosis and the limited array of treatment modalities. Patient presentation varies considerably and symptoms may include low back, groin, and radicular pain, leading to the potential for inaccurate diagnosis. Recently there has been resurgence in the SIJ as new MIS treatments have become available. The purpose of this retrospective study is to evaluate the safety and effectiveness of MIS SI joint arthrodesis using a series of triangular, implants.
Methods: An IRB approved retrospective medical chart review of the first 20 consecutive patients treated with MIS SI joint fusion unilaterally by a single surgeon was undertaken. Charts were reviewed for baseline demographics, complications, symptom type and duration. Clinical outcomes include VAS pain scores and satisfaction with surgery. Data were reviewed pre-operatively through 12 months post-operatively.
Results: Mean age was 63 (range 39-82), patients were mostly female (65%) and 60% had prior lumbar spinal fusion with instrumentation. Immediate post-op complications include urinary retention (n=1) and hematoma (n=1). There were 3 (15%) incidents of transient trochanteric bursitis. Continuing pain in one patient was resolved after subsequent facet rhizotomy at L5/S1. At 3 months post-op, 1 patient presented with new radicular pain. CT scan revealed the most cephalad implant was violating the anterior cortex and was subsequently removed, alleviating the patient’s symptoms.
Mean pain scores improved clinically (>5pt change) and significantly (p<0.000) at all time points. Patient satisfaction was high: 95% were somewhat to very satisfied with the results of surgery and 89% would have the same surgery for the same results.
Conclusions: When conservative measures fail, MIS SI joint arthrodesis using a series of triangular porous plasma coated implants is a safe and effective treatment option in carefully selected patients.
Patient Care: Investigating outcomes of a new minimally invasive treatment procedure for patients with low back pain.
Learning Objectives: By the end of this session, participants should be able to better understand 1) reported complications and 2) clinical outcomes of MIS SIJ fusion surgery.