Outcomes After Minimally Invasive Sacroiliac Joint Fusion: A Scoping Review

• Published in: World neurosurgery 2022-12, Vol.168, p.120-132
• Main Authors: Mehkri, Yusuf, Tishad, Abtahi, Nichols, Spencer, Scott, Kyle W., Arias, Jonathan, Lucke-Wold, Brandon, Rahmathulla, Gazanfar
• Format: Article
• Language: English
• Subjects: Fusion; Humans; Low Back Pain - surgery; Minimally invasive; Minimally Invasive Surgical Procedures - methods; Outcomes; Sacroiliac joint; Sacroiliac Joint - surgery; Spinal Diseases - surgery; Spinal Fusion - methods
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2022.09.094

Sacroiliac joint (SIJ) dysfunction is a significant contributor to lower back pain. Although open surgical treatment for persistent pain has long been the standard, it is associated with significant surgical morbidity, high complication rates, and variable patient satisfaction. Minimally invasive SIJ fusion (MISJF) is a promising and effective approach. This scoping review was carried out to map the available evidence on outcomes after MISJF. This review was conducted in accordance with the PRISMA guidelines. Inclusion criteria were all full-text articles reporting on functional, clinical, and quality-of-life outcomes after MISJF. Exclusion criteria consisted of studies including patients with traumatic sacroiliac injuries or congenital spinal abnormalities, and procedures involving multiple spinal fusions or an open approach to SIJ fusion. A total of 1305 studies were identified across 6 databases. After duplicate removal and further screening, 33 independent studies were included in our review. Regarding pain management, 21 studies reported visual analog scale scores, and all showed significant (>50%) reductions in pain at multiple time points postoperatively. Six studies reported on quality-of-life outcomes and showed significant increases, especially compared with nonsurgical treatment. This study highlights the existing literature regarding outcomes after MISJF. MISJF provides favorable responses in quality-of-life metrics, pain scores, and overall postoperative outcomes in select patients. Although outcomes have been widely studied, more studies, especially prospectively designed and those without industry influence, should be performed to elucidate the optimal management of patients with intractable SIJ pain.