Poster Presentation Sydney Spinal Symposium 2022

Fusion techniques of the Sacroiliac joint in traumatic and non-traumatic conditions (#112)

Kalaventhan Pathinathan 1 , Alisha W Sial 2 , Xiaolong Chen 3 4 , Neha Chopra 5 , Ashish D Diwan 6
  1. Department of Orthopaedic Surgery, St. George Hospital Campus, Clinical Fellow, Kogarah, NSW, Australia
  2. Department of Orthopaedic surgery, ST. George Hospital Campus, Clinical & Research Fellow, Kogarah, NSW, Australia
  3. Spine labs, St.George & Sutherland Clinical School, University of New South Wales, Project Manager, Kogarah, NSW, Australia
  4. Spine Service, Department of Orthopaedic Surgery, Senior Lecturer, St. George & Sutherland Clinical School, University of New South Wales, , Kogarah, NSW, Australia
  5. St. George & Sutherland Clinical School, University of New South Wales, Clinical Trial Coordinator, Kogarah, NSW, Australia
  6. Department of Orthopaedic Surgery, St. George Hospital & University of New South Wales, Director Spine Service, Kogarah, NSW, Australia

Introduction

Sacroiliac joint fusion strategies are successful in patients who are well selected. There are several methods described. In any arthrodesis, the principles followed are: articular surface preparation, compression of articular surfaces, augmenting with bone graft and achieving stable fixation without affecting the native joint stability. Because of the anatomical topography and complex innervation, following all these principles are difficult for sacroiliac joint surgical fusion. The purpose of this study is to compare the available techniques for the fusion of sacroiliac joint and their outcome.

Methods

A literature review has been performed for randomized controlled trials to find out the best sacroiliac fusion strategy with good outcome measures. Closed reduction/ open reduction and percutaneous screw fixation or open fixation using plates and screws, intraarticular porous coated metal bar insertion, open debridement and percutaneous screw fixation are compared, and their outcome is discussed.

Discussion

In studies analyzing open surgical techniques, computed tomography (CT) has been used to assess the fusion. Fusion was achieved in 20-90% of cases. Excellent satisfaction was obtained in 18-100%. Poor outcome was observed in 0-47%. The re-operation rate was 0-65%. In studies analyzing minimal invasive techniques, CT and radiographs were used to assess the fusion rate. Excellent outcome was observed in 56-100% and the reoperation rate was 0-17%.

Conclusion

Sacroiliac joint fusion is a viable option for a carefully selected group of patients with sacroiliac joint dysfunction. There are few quality studies available in this field. Anyway, prospective randomized controlled studies with the scope of assessing the long-term outcome are still lacking. Further, meta-analyses are necessary to understand the long-term outcome and complications of sacroiliac joint fusion.