Double-center observational study of minimally invasive sacroiliac joint fusion for sacroiliac joint dysfunction: one-year results.


Journal

Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112

Informations de publication

Date de publication:
28 Dec 2022
Historique:
received: 18 10 2022
accepted: 21 12 2022
entrez: 27 12 2022
pubmed: 28 12 2022
medline: 30 12 2022
Statut: epublish

Résumé

For a substantial part of patients with chronic low back pain, the origin is located in the sacroiliac joint (SIJ). Minimally invasive sacroiliac joint fusion (MISJF) is increasingly being implemented as a treatment option in SIJ dysfunction. Despite remaining controversy, evidence continues to increase. This study evaluates the clinical results and safety of MISJF in a double-center consecutive case series in patients with SIJ dysfunction over a one-year observation period. SIJ complaints were diagnosed after history taking, physical examination and least a 50% reduction of SIJ pain 30-60 min following image-guided injection. Primary outcome measures were patient reported outcome measurements (PROMs), consisting of Visual Analogue Scale (VAS) pain score and EuroQol 5-dimensions 3-levels (EQ-5D-3L). Patients' perspectives on the effects of surgery were collected through questionnaires. Secondary outcome measures were implant positioning and (serious) adverse events ((S)AE's). A total of 29 patients were included. In 44.8% of patients, SIJ dysfunction was of postpartum origin. The mean VAS-pain score improved from 7.83 (± 1.71) to 4.97 (± 2.63) postoperatively (p < 0.001). EQ-5D-3L score improved from 0.266 (± 0.129) to 0.499 (± 0.260) postoperatively (p < 0.001). Opioid consumption decreased from 44.8 to 24.1% postoperatively (p = 0.026). In 13.7% of patients, an (S)AE occurred. MISJF appears to be an effective and safe procedure in this cohort. Statistically significant and clinically relevant improvements in pain and quality of life were observed one-year postoperatively. Future studies should focus on the long-term outcomes to further evaluate the safety and effectiveness of MISJF.

Sections du résumé

BACKGROUND BACKGROUND
For a substantial part of patients with chronic low back pain, the origin is located in the sacroiliac joint (SIJ). Minimally invasive sacroiliac joint fusion (MISJF) is increasingly being implemented as a treatment option in SIJ dysfunction. Despite remaining controversy, evidence continues to increase. This study evaluates the clinical results and safety of MISJF in a double-center consecutive case series in patients with SIJ dysfunction over a one-year observation period.
METHODS METHODS
SIJ complaints were diagnosed after history taking, physical examination and least a 50% reduction of SIJ pain 30-60 min following image-guided injection. Primary outcome measures were patient reported outcome measurements (PROMs), consisting of Visual Analogue Scale (VAS) pain score and EuroQol 5-dimensions 3-levels (EQ-5D-3L). Patients' perspectives on the effects of surgery were collected through questionnaires. Secondary outcome measures were implant positioning and (serious) adverse events ((S)AE's).
RESULTS RESULTS
A total of 29 patients were included. In 44.8% of patients, SIJ dysfunction was of postpartum origin. The mean VAS-pain score improved from 7.83 (± 1.71) to 4.97 (± 2.63) postoperatively (p < 0.001). EQ-5D-3L score improved from 0.266 (± 0.129) to 0.499 (± 0.260) postoperatively (p < 0.001). Opioid consumption decreased from 44.8 to 24.1% postoperatively (p = 0.026). In 13.7% of patients, an (S)AE occurred.
CONCLUSION CONCLUSIONS
MISJF appears to be an effective and safe procedure in this cohort. Statistically significant and clinically relevant improvements in pain and quality of life were observed one-year postoperatively. Future studies should focus on the long-term outcomes to further evaluate the safety and effectiveness of MISJF.

Identifiants

pubmed: 36575465
doi: 10.1186/s13018-022-03466-x
pii: 10.1186/s13018-022-03466-x
pmc: PMC9794474
doi:

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

570

Informations de copyright

© 2022. The Author(s).

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Auteurs

Sem M M Hermans (SMM)

Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Heerlen, The Netherlands. semhermans@hotmail.com.
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands. semhermans@hotmail.com.

Rob J H Knoef (RJH)

Department of Orthopaedic Surgery, Medical Spectrum Twente, Enschede, The Netherlands.

Valérie N E Schuermans (VNE)

Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Department of Neurosurgery, Maastricht University Medical Center +, Maastricht, The Netherlands.
Department of Neurosurgery, Zuyderland Medical Center, Heerlen, The Netherlands.

Martijn G M Schotanus (MGM)

Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Heerlen, The Netherlands.
Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

Jorm M Nellensteijn (JM)

Department of Orthopaedic Surgery, Medical Spectrum Twente, Enschede, The Netherlands.

Henk van Santbrink (H)

Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Department of Neurosurgery, Maastricht University Medical Center +, Maastricht, The Netherlands.
Department of Neurosurgery, Zuyderland Medical Center, Heerlen, The Netherlands.

Inez Curfs (I)

Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Heerlen, The Netherlands.

Wouter L W van Hemert (WLW)

Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Heerlen, The Netherlands.

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