Vikas Patel, S Craig Meyer, Don Kovalsky, Harry Lockstadt, Jim Farris, Robert Limoni, Abhineet Chowdhary, Philip Yuan, Casey Langel, Andy Kranenburg, Gabriel Tender
{"title":"使用 3D 打印三角形钛植入物进行骶髂关节融合术的前瞻性试验:5年随访。","authors":"Vikas Patel, S Craig Meyer, Don Kovalsky, Harry Lockstadt, Jim Farris, Robert Limoni, Abhineet Chowdhary, Philip Yuan, Casey Langel, Andy Kranenburg, Gabriel Tender","doi":"10.1097/BRS.0000000000005170","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Prospective, multicenter, single-arm study with five-year follow up.</p><p><strong>Objective: </strong>To report long-term (five years) safety, effectiveness, and radiographic outcomes after sacroiliac (SI) joint fusion (SIJF) with 3D-printed triangular titanium implants (TTI) and compare them with solid titanium plasma spray coated implants.</p><p><strong>Summary of background data: </strong>A large literature base supports minimally invasive SIJF with TTI for chronic SIJ dysfunction.</p><p><strong>Materials and methods: </strong>SIJF with TTI was performed in 51 subjects and scheduled follow-up occurred at 3, 6, 12, 24, and 60 months. Postoperative visits included quality of life questionnaires and functional tests. A high-resolution CT scan was performed at either 6 or 12 months, and again at 60 months. All CT scans were interpreted by an independent musculoskeletal radiologist.</p><p><strong>Results: </strong>Five-year follow-up was available in 36 of 51 subjects (71%). At five years, improvements in SI joint pain [58.1 points (0-100 scale)], SIJ-related disability [Oswestry disability index (ODI), 25.4 points) and quality of life (EuroQOL 5D: 0.24 points and EuroQOL visual analog scale: 13.4 points) were sustained and showed no signs of diminution. The percentage of patients using opioids for SIJ pain decreased markedly from baseline (57%) to five years (17%). Physical function tests showed persistent improvements from baseline. There was no evidence of device breakage, migration or subsidence and few late adverse events occurred attributable to the device. Independent analysis of CT scans showed bone opposed to implants in all cases, and evidence of bone bridging in 90% of cases, and no evidence of radiolucency or other adverse bone reactions.</p><p><strong>Conclusions: </strong>Prospective five-year follow-up showed that SIJ fusion using 3D-printed TTI resulted in immediate, marked, and persistent improvements in pain and quality of life, with improved physical function, reduced opioid use, and a low rate of revision surgery. Radiographic evidence showed implant integration and joint fusion.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"620-627"},"PeriodicalIF":2.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970590/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prospective Trial of Sacroiliac Joint Fusion Using 3D-Printed Triangular Titanium Implants: Five-Year Follow-Up.\",\"authors\":\"Vikas Patel, S Craig Meyer, Don Kovalsky, Harry Lockstadt, Jim Farris, Robert Limoni, Abhineet Chowdhary, Philip Yuan, Casey Langel, Andy Kranenburg, Gabriel Tender\",\"doi\":\"10.1097/BRS.0000000000005170\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Prospective, multicenter, single-arm study with five-year follow up.</p><p><strong>Objective: </strong>To report long-term (five years) safety, effectiveness, and radiographic outcomes after sacroiliac (SI) joint fusion (SIJF) with 3D-printed triangular titanium implants (TTI) and compare them with solid titanium plasma spray coated implants.</p><p><strong>Summary of background data: </strong>A large literature base supports minimally invasive SIJF with TTI for chronic SIJ dysfunction.</p><p><strong>Materials and methods: </strong>SIJF with TTI was performed in 51 subjects and scheduled follow-up occurred at 3, 6, 12, 24, and 60 months. Postoperative visits included quality of life questionnaires and functional tests. A high-resolution CT scan was performed at either 6 or 12 months, and again at 60 months. All CT scans were interpreted by an independent musculoskeletal radiologist.</p><p><strong>Results: </strong>Five-year follow-up was available in 36 of 51 subjects (71%). At five years, improvements in SI joint pain [58.1 points (0-100 scale)], SIJ-related disability [Oswestry disability index (ODI), 25.4 points) and quality of life (EuroQOL 5D: 0.24 points and EuroQOL visual analog scale: 13.4 points) were sustained and showed no signs of diminution. The percentage of patients using opioids for SIJ pain decreased markedly from baseline (57%) to five years (17%). Physical function tests showed persistent improvements from baseline. There was no evidence of device breakage, migration or subsidence and few late adverse events occurred attributable to the device. Independent analysis of CT scans showed bone opposed to implants in all cases, and evidence of bone bridging in 90% of cases, and no evidence of radiolucency or other adverse bone reactions.</p><p><strong>Conclusions: </strong>Prospective five-year follow-up showed that SIJ fusion using 3D-printed TTI resulted in immediate, marked, and persistent improvements in pain and quality of life, with improved physical function, reduced opioid use, and a low rate of revision surgery. Radiographic evidence showed implant integration and joint fusion.</p><p><strong>Level of evidence: </strong>Level II.</p>\",\"PeriodicalId\":22193,\"journal\":{\"name\":\"Spine\",\"volume\":\" \",\"pages\":\"620-627\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970590/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BRS.0000000000005170\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005170","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Prospective Trial of Sacroiliac Joint Fusion Using 3D-Printed Triangular Titanium Implants: Five-Year Follow-Up.
Study design: Prospective, multicenter, single-arm study with five-year follow up.
Objective: To report long-term (five years) safety, effectiveness, and radiographic outcomes after sacroiliac (SI) joint fusion (SIJF) with 3D-printed triangular titanium implants (TTI) and compare them with solid titanium plasma spray coated implants.
Summary of background data: A large literature base supports minimally invasive SIJF with TTI for chronic SIJ dysfunction.
Materials and methods: SIJF with TTI was performed in 51 subjects and scheduled follow-up occurred at 3, 6, 12, 24, and 60 months. Postoperative visits included quality of life questionnaires and functional tests. A high-resolution CT scan was performed at either 6 or 12 months, and again at 60 months. All CT scans were interpreted by an independent musculoskeletal radiologist.
Results: Five-year follow-up was available in 36 of 51 subjects (71%). At five years, improvements in SI joint pain [58.1 points (0-100 scale)], SIJ-related disability [Oswestry disability index (ODI), 25.4 points) and quality of life (EuroQOL 5D: 0.24 points and EuroQOL visual analog scale: 13.4 points) were sustained and showed no signs of diminution. The percentage of patients using opioids for SIJ pain decreased markedly from baseline (57%) to five years (17%). Physical function tests showed persistent improvements from baseline. There was no evidence of device breakage, migration or subsidence and few late adverse events occurred attributable to the device. Independent analysis of CT scans showed bone opposed to implants in all cases, and evidence of bone bridging in 90% of cases, and no evidence of radiolucency or other adverse bone reactions.
Conclusions: Prospective five-year follow-up showed that SIJ fusion using 3D-printed TTI resulted in immediate, marked, and persistent improvements in pain and quality of life, with improved physical function, reduced opioid use, and a low rate of revision surgery. Radiographic evidence showed implant integration and joint fusion.
期刊介绍:
Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store.
Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.