Lateral fusion

Sacroiliac joint pain and dysfunction has increasingly been identified as an important pain generator in patients with chronic back pain or failed back surgery syndrome, and it is estimated to account for 15% to 30% of low back pain cases. Historically, fusion of the joint has been performed with an open posterior or posterolateral approach. Minimally invasive surgical (MIS) approaches were introduced in 2008, and since that time MIS posterior and lateral approaches have become common. Numerous medical device companies have marketed MIS systems, and evidence of their safety and efficacy is mounting. This chapter will detail lateral MIS approaches using fluoroscopic and navigation system guidance, as well as the posterolateral open approach, also known as the modified Smith-Petersen approach. Evidence for safety and efficacy of lateral sacroiliac joint fusion will also be discussed.