Patient-Reported and Radiological Outcomes of Primary Bilateral Sacroiliac Joint Fusion Using a Principles-Based Approach.

IF 1.7 Q2 SURGERY

International Journal of Spine Surgery Pub Date : 2025-09-11 DOI:10.14444/8789

Megan L Anderson, Nicholas G Rhodes, Michelle Y Hung, Ankur Khanna, William W Cross

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引用次数: 0

Abstract

Background: Bilateral sacroiliac joint fusion (BSIJF) is an accepted management strategy for sacroiliac joint dysfunction, though outcomes data are limited by patient number and lack of long-term follow-up. This study investigated the clinical, radiological, and patient-reported outcomes of BSIJF.

Methods: A retrospective review was conducted of all patients who underwent BSIJF with a single surgeon between 2020 and 2023. All BSIJF utilized a principles-based approach: joint decortication, bone grafting, compression, and rigid stability. Patient-reported outcomes at preoperative, 6-month, 1-year, and 2-year follow-up timepoints were recorded for the Numeric Pain Rating Scale, Oswestry Disability Index (ODI), Single Assessment Numeric Evaluation (SANE), PROMIS Pain Interference (PI), and PROMIS Physical Function (PF). Fusion grading was assessed by computed tomography after 1 and 2 years.

Results: Forty-eight patients who underwent BSIJF were included, of whom 31 (65%) were women with a mean age of 54 ± 14 years and a mean body mass index of 29 ± 5. Twenty-five patients (52%) had prior lumbar spine surgery (PLSS). One patient required revision for implant malpositioning and nerve impingement. Bridging bone across the sacroiliac joint was observed in 85% of patients. Numeric Pain Rating Scale scores dropped significantly from 7.6 preoperatively to 3.9, 3.3, and 3.7 at 6-month, 1-year, and 2-year follow-ups, respectively (P ≤ 0.004). PI and PF scores were significantly improved at all timepoints (all P < 0.001). ODI scores demonstrated sustained improvement from 52.3 preoperatively to 33.3 at 1-year follow-up and 29.3 at 2-year follow-up (P < 0.001). SANE scores were 80% at 1-year follow-up and 85% at 2-year follow-up. PI, PF, and ODI scores were significantly improved at all timepoints, independent of PLSS status. The mean SANE score in patients with PLSS was 82% ± 22% at 2-year follow-up. Patient history of hip surgery prior to BSIJF was associated with inferior postoperative ODI and SANE scores.

Conclusions: BSIJF is a safe and effective treatment that is associated with high rates of bony bridging at the sacroiliac joint and long-term clinically significant improvements in pain and function.

Level of evidence: 4:

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采用基于原则的入路进行双侧骶髂关节融合的患者报告和放射学结果。

背景：双侧骶髂关节融合术（BSIJF）是一种公认的治疗骶髂关节功能障碍的策略，尽管结果数据受患者数量和缺乏长期随访的限制。本研究调查了BSIJF的临床、放射学和患者报告的结果。方法：对2020年至2023年间接受单一外科医生BSIJF的所有患者进行回顾性分析。所有BSIJF均采用基于原则的方法：关节去皮、植骨、加压和刚性稳定。在术前、6个月、1年和2年随访时间点记录患者报告的结果，包括数字疼痛评定量表、Oswestry残疾指数（ODI）、单一评估数字评估（SANE）、PROMIS疼痛干扰（PI）和PROMIS身体功能（PF）。1年和2年后通过计算机断层扫描评估融合评分。结果：纳入48例BSIJF患者，其中31例（65%）为女性，平均年龄54±14岁，平均体重指数29±5。25例（52%）患者既往有腰椎手术（PLSS）。1例患者因种植体错位和神经撞击需要翻修。在85%的患者中观察到横跨骶髂关节的桥接骨。数值疼痛评定量表评分分别从术前7.6分降至随访6个月、1年和2年的3.9分、3.3分和3.7分（P≤0.004）。PI和PF评分在各时间点均显著提高（均P < 0.001）。ODI评分从术前的52.3分持续改善到随访1年的33.3分和随访2年的29.3分（P < 0.001）。1年随访时，SANE评分为80%，2年随访时为85%。PI、PF和ODI评分在所有时间点均显著改善，与PLSS状态无关。在2年随访中，PLSS患者的平均SANE评分为82%±22%。BSIJF前髋关节手术史与术后ODI和SANE评分较低相关。结论：BSIJF是一种安全有效的治疗方法，与骶髂关节骨桥搭桥率高，疼痛和功能的长期临床显着改善有关。证据等级：4；

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Spine Surgery Medicine-Surgery

CiteScore

3.10

自引率

0.00%

发文量

162

期刊介绍： The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.