Skip to main content
Top
Published in: European Spine Journal 10/2013

01-10-2013 | Original Article

Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?

Authors: Nate Slinkard, Julie Agel, Marc F. Swiontkowski

Published in: European Spine Journal | Issue 10/2013

Login to get access

Abstract

Purpose

The purpose of this prospective case series (level II) was to determine the clinical outcomes of anterior SIJ fusion, comparing the outcomes of patients who had prior spinal fusions at any level compared to patients who have not.

Methods

This prospective study included 25 patients who underwent SIJ fusion with anterior plate fixation. All patients had failed non-operative treatment, had a positive Patrick test, and positive response to intra-articular SIJ injections with greater than 50 % pain relief. Patients had follow-up at 3, 6, 9 and 12 months where they completed Oswestry disability index (ODI) and Short Musculoskeletal Functional Assessment (SMFA) surveys. Outcome data are available for 19 patients who completed pre-operative and 12-month follow-up surveys. Their average time of the final follow-up was 1.1 years (range 10–33 months).

Results

Significant improvements between pre-operative and the final follow-up in ODI (p = 0.007) and SMFA (p = 0.01) were observed; the ODI assessed outcomes in patients who had previous spinal fusion surgery were significantly worse than those that did not at the final follow-up (p = 0.04).

Conclusion

Patients who have not undergone prior spinal fusion surgery, regardless of age, gender, and BMI have better outcomes following anterior SIJ fusion.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fortin JD, Aprill CN, Ponthieux B, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part II: clinical evaluation. Spine 19:1483–1489PubMedCrossRef Fortin JD, Aprill CN, Ponthieux B, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part II: clinical evaluation. Spine 19:1483–1489PubMedCrossRef
2.
go back to reference Fortin JD, Dwyer AP, West S, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part I: asymptomatic volunteers. Spine 19:1475–1482PubMedCrossRef Fortin JD, Dwyer AP, West S, Pier J (1994) Sacroiliac joint: pain referral maps upon applying a new injection/arthrography technique. Part I: asymptomatic volunteers. Spine 19:1475–1482PubMedCrossRef
3.
go back to reference Dreyfuss P, Michaelsen M, Pauza K, McLarty J, Bogduk N (1996) The value of medical history and physical examination in diagnosing sacroiliac joint pain. Spine 21:2594–2602PubMedCrossRef Dreyfuss P, Michaelsen M, Pauza K, McLarty J, Bogduk N (1996) The value of medical history and physical examination in diagnosing sacroiliac joint pain. Spine 21:2594–2602PubMedCrossRef
4.
go back to reference Bernard T, Cassidy J (1999) The sacroiliac joint syndrome: pathophysiology, diagnosis, and management. The adult spine: principles and practice, 2nd edn. Lippincott-Raven, Philadelphia, pp 2343–2366 Bernard T, Cassidy J (1999) The sacroiliac joint syndrome: pathophysiology, diagnosis, and management. The adult spine: principles and practice, 2nd edn. Lippincott-Raven, Philadelphia, pp 2343–2366
5.
go back to reference Maigne JY, Planchon CA (2005) Sacroiliac joint pain after lumbar fusion. A study with anesthetic blocks. Eur Spine J 14:654–658PubMedCrossRef Maigne JY, Planchon CA (2005) Sacroiliac joint pain after lumbar fusion. A study with anesthetic blocks. Eur Spine J 14:654–658PubMedCrossRef
6.
go back to reference Schwarzer AC, Aprill CN, Bogduk N (1995) The sacroiliac joint in chronic low back pain. Spine 20:31–37PubMedCrossRef Schwarzer AC, Aprill CN, Bogduk N (1995) The sacroiliac joint in chronic low back pain. Spine 20:31–37PubMedCrossRef
7.
go back to reference Ha KY, Lee JS, Kim KW (2008) Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up. Spine 33:1192–1198PubMedCrossRef Ha KY, Lee JS, Kim KW (2008) Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up. Spine 33:1192–1198PubMedCrossRef
8.
go back to reference Zelle BA, Gruen GS, Brown S, George S (2005) Sacroiliac joint dysfunction: evaluation and management. Clin J Pain 21:446–455PubMedCrossRef Zelle BA, Gruen GS, Brown S, George S (2005) Sacroiliac joint dysfunction: evaluation and management. Clin J Pain 21:446–455PubMedCrossRef
9.
go back to reference Schutz U, Grob D (2006) Poor outcome following bilateral sacroiliac joint fusion for degenerative sacroiliac joint syndrome. Acta Orthop Belg 72:296–308PubMed Schutz U, Grob D (2006) Poor outcome following bilateral sacroiliac joint fusion for degenerative sacroiliac joint syndrome. Acta Orthop Belg 72:296–308PubMed
10.
go back to reference van der Wurff P, Meyne W, Hagmeijer RH (2000) Clinical tests of the sacroiliac joint. Man Ther 5:89–96PubMedCrossRef van der Wurff P, Meyne W, Hagmeijer RH (2000) Clinical tests of the sacroiliac joint. Man Ther 5:89–96PubMedCrossRef
11.
go back to reference van der Wurff P, Hagmeijer RH, Meyne W (2000) Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: reliability. Man Ther 5:30–36PubMedCrossRef van der Wurff P, Hagmeijer RH, Meyne W (2000) Clinical tests of the sacroiliac joint. A systematic methodological review. Part 1: reliability. Man Ther 5:30–36PubMedCrossRef
12.
go back to reference Freburger JK, Riddle DL (2001) Using published evidence to guide the examination of the sacroiliac joint region. Phys Ther 81:1135–1143PubMed Freburger JK, Riddle DL (2001) Using published evidence to guide the examination of the sacroiliac joint region. Phys Ther 81:1135–1143PubMed
13.
go back to reference Kokmeyer DJ, Van der Wurff P, Aufdemkampe G, Fickenscher TC (2002) The reliability of multitest regimens with sacroiliac pain provocation tests. J Manip Physiol Ther 25:42–48CrossRef Kokmeyer DJ, Van der Wurff P, Aufdemkampe G, Fickenscher TC (2002) The reliability of multitest regimens with sacroiliac pain provocation tests. J Manip Physiol Ther 25:42–48CrossRef
14.
go back to reference Laslett M, Young SB, Aprill CN, McDonald B (2003) Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust J Physiother 49:89–97PubMed Laslett M, Young SB, Aprill CN, McDonald B (2003) Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust J Physiother 49:89–97PubMed
15.
go back to reference Laslett M, Aprill CN, McDonald B (2006) Provocation sacroiliac joint tests have validity in the diagnosis of sacroiliac joint pain. Arch Phys Med Rehabil 87:874 (author reply 874–875)PubMedCrossRef Laslett M, Aprill CN, McDonald B (2006) Provocation sacroiliac joint tests have validity in the diagnosis of sacroiliac joint pain. Arch Phys Med Rehabil 87:874 (author reply 874–875)PubMedCrossRef
16.
go back to reference Maigne JY, Aivaliklis A, Pfefer F (1996) Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine 21:1889–1892PubMedCrossRef Maigne JY, Aivaliklis A, Pfefer F (1996) Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine 21:1889–1892PubMedCrossRef
17.
go back to reference Potter NA, Rothstein JM (1985) Intertester reliability for selected clinical tests of the sacroiliac joint. Phys Ther 65:1671–1675PubMed Potter NA, Rothstein JM (1985) Intertester reliability for selected clinical tests of the sacroiliac joint. Phys Ther 65:1671–1675PubMed
18.
go back to reference Riddle DL, Freburger JK (2002) Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: a multicenter intertester reliability study. Phys Ther 82:772–781PubMed Riddle DL, Freburger JK (2002) Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: a multicenter intertester reliability study. Phys Ther 82:772–781PubMed
19.
go back to reference Dreyfuss P, Dreyer SJ, Cole A, Mayo K (2004) Sacroiliac joint pain. J Am Acad Orthop Surg 12:255–265PubMed Dreyfuss P, Dreyer SJ, Cole A, Mayo K (2004) Sacroiliac joint pain. J Am Acad Orthop Surg 12:255–265PubMed
20.
go back to reference Fairbank JC, Pynsent PB (2000) The Oswestry disability index. Spine (Phila Pa 1976) 25:2940–2952 (discussion 2952)CrossRef Fairbank JC, Pynsent PB (2000) The Oswestry disability index. Spine (Phila Pa 1976) 25:2940–2952 (discussion 2952)CrossRef
21.
go back to reference Hudson-Cook N, Tomes-Nicholson K, Breen A (1989) A revised Oswestry disability questionnaire. In: Roland M, Jenner J (eds) Back pain: new approaches to rehabilitation and education. Manchester University Press, Manchester, pp 187–204 Hudson-Cook N, Tomes-Nicholson K, Breen A (1989) A revised Oswestry disability questionnaire. In: Roland M, Jenner J (eds) Back pain: new approaches to rehabilitation and education. Manchester University Press, Manchester, pp 187–204
22.
go back to reference Swiontkowski MF, Engelberg R, Martin DP, Agel J (1999) Short musculoskeletal function assessment questionnaire: validity, reliability and responsiveness. J Bone Joint Surg (Am) 81:1245–1260CrossRef Swiontkowski MF, Engelberg R, Martin DP, Agel J (1999) Short musculoskeletal function assessment questionnaire: validity, reliability and responsiveness. J Bone Joint Surg (Am) 81:1245–1260CrossRef
23.
go back to reference Laslett M, Aprill CN, McDonald B, Young SB (2005) Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 10:207–218PubMedCrossRef Laslett M, Aprill CN, McDonald B, Young SB (2005) Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 10:207–218PubMedCrossRef
24.
go back to reference Belanger TA, Dall BE (2001) Sacroiliac arthrodesis using a posterior midline fascial splitting approach and pedicle screw instrumentation: a new technique. J Spinal Disord 14:118–124PubMedCrossRef Belanger TA, Dall BE (2001) Sacroiliac arthrodesis using a posterior midline fascial splitting approach and pedicle screw instrumentation: a new technique. J Spinal Disord 14:118–124PubMedCrossRef
25.
go back to reference Buchowski JM, Kebaish KM, Sinkov V, Cohen DB, Sieber AN, Kostuik JP (2005) Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint. Spine J 5:520–528 (discussion 529)PubMedCrossRef Buchowski JM, Kebaish KM, Sinkov V, Cohen DB, Sieber AN, Kostuik JP (2005) Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint. Spine J 5:520–528 (discussion 529)PubMedCrossRef
26.
go back to reference Waisbrod H, Krainick JU, Gerbershagen HU (1987) Sacroiliac joint arthrodesis for chronic lower back pain. Arch Orthop Trauma Surg 106:238–240PubMedCrossRef Waisbrod H, Krainick JU, Gerbershagen HU (1987) Sacroiliac joint arthrodesis for chronic lower back pain. Arch Orthop Trauma Surg 106:238–240PubMedCrossRef
27.
go back to reference Daum WJ (1995) The sacroiliac joint: an underappreciated pain generator. Am J Orthop (Belle Mead NJ) 24:475–478 Daum WJ (1995) The sacroiliac joint: an underappreciated pain generator. Am J Orthop (Belle Mead NJ) 24:475–478
28.
go back to reference Simonian PT, Routt ML Jr, Harrington RM, Mayo KA, Tencer AF (1994) Biomechanical simulation of the anteroposterior compression injury of the pelvis. An understanding of instability and fixation. Clin Orthop Relat Res 309:245–256PubMed Simonian PT, Routt ML Jr, Harrington RM, Mayo KA, Tencer AF (1994) Biomechanical simulation of the anteroposterior compression injury of the pelvis. An understanding of instability and fixation. Clin Orthop Relat Res 309:245–256PubMed
29.
go back to reference Leighton RK, Waddell JP (1996) Techniques for reduction and posterior fixation through the anterior approach. Clin Orthop Relat Res 329:115–120PubMedCrossRef Leighton RK, Waddell JP (1996) Techniques for reduction and posterior fixation through the anterior approach. Clin Orthop Relat Res 329:115–120PubMedCrossRef
30.
go back to reference Rand JA (1985) Anterior sacro-iliac arthrodesis for post-traumatic sacro-iliac arthritis. A case report. J Bone Joint Surg Am 67:157–159PubMed Rand JA (1985) Anterior sacro-iliac arthrodesis for post-traumatic sacro-iliac arthritis. A case report. J Bone Joint Surg Am 67:157–159PubMed
31.
go back to reference Simpson LA, Waddell JP, Leighton RK, Kellam JF, Tile M (1987) Anterior approach and stabilization of the disrupted sacroiliac joint. J Trauma 27:1332–1339PubMedCrossRef Simpson LA, Waddell JP, Leighton RK, Kellam JF, Tile M (1987) Anterior approach and stabilization of the disrupted sacroiliac joint. J Trauma 27:1332–1339PubMedCrossRef
Metadata
Title
Documentation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence the outcome?
Authors
Nate Slinkard
Julie Agel
Marc F. Swiontkowski
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 10/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-2968-1

Other articles of this Issue 10/2013

European Spine Journal 10/2013 Go to the issue