Patient selection

Abstract

Sacroiliac joint fusion has become a mainstay of the treatment of low back pain for both surgeons and interventionalists. This chapter discusses proper patient selection for both open and minimally invasive sacroiliac joint fusion techniques. Topics covered are indications and contraindications for surgery as well as imaging modalities that the provider can use to ascertain the integrity of the sacroiliac joint when fusion is being considered. It is important to assess each patient’s psychiatric history and current psychiatric symptoms, weigh the benefits and the risks of the procedure, and then use clinical judgment before proceeding with surgery. A brief overview of the two most common surgical approaches (lateral and posterior), along with survivorship data, is provided. Other patient considerations include bone density, previous lumbar spine surgery, smoking history, and comorbidities such as diabetes mellitus.