| Author, Year | N | Demographics | Diagnostic Standard | Surgical Procedure/Post-Op Care | Results | Complications |
|---|---|---|---|---|---|---|
| Kibsgard, 2012 [33] | 50, 28 | Fusion (50 pts) Age: 58 Gender: 47F/3M Follow-up: 23 yrs Unilateral 21/Bilateral 25 Dx: Post-partum (30), Trauma (8), Idiopathic (12) Non-Surgery (28 pts) Age: 52 Gender: 28F Follow-up: 17 yrs |
PSIS tenderness, positive straight leg raise, positive provocative maneuvers | Trans-iliac fusion or intra/extra-articular fusion between the ilium and the sacrum using cortical iliac window and iliac crest autograft.
Post-op care: In most cases the patients were confined to 6 weeks of bed rest. |
Surgical patients after 1 year: 24 (48%) patients were good, 12 (24%) were fair, and 14 (28%) were poor.
No significant difference in ODI, VAS, or SF-36 between surgery and non-surgery patients after long-term follow-up. |
Reoperation: 7 Nonunion: 8 Jaundice: 1 Pulmonary embolism: 1 Pin tract infection: 1 Complication rate: 20% Revision rate: 14% |
| Khurana, 2009 [31] | 15 | Age: 48.7 years Gender 11F/4M Follow-up: 17 months Unilateral 11/Bilateral 4 Previous lumbar surgery: 6 Dx: Osteoarthritis (7), SI joint dysfunction(4), SI joint instability (3), Inflammatory Arthritis (1) |
Tenderness over the posterior SI joint, positive provocative maneuvers, pain relief with SI joint block | 10 mm Hollow Modular Anchorage Screw packed with demineralized bone matrix across the SI joint. Post-op care: Partial weight bearing for six weeks and full weight bearing by 12 weeks. |
Blood loss: < 50 ml LOS 2.7 days SF-36 increased: PF 37 to 80, GH 53 to 86 Majeed's: 37 to 79 Good/Excellent: 13/15 Fusion in all patients |
None reported |
| Al-Khayer 2008 [16] | 9 | Age: 42 years Gender: 9F Follow-up: 40 mo Unilateral 6 /Bilateral 3 Symptom Duration: 30 mo Prior treatments: Failed conservative treatment Dx: Chronic SI joint pain |
Tenderness over the sacral sulcus, positive provocative maneuvers, X-rays to exclude other pain sources, relief from SI joint block | 10 mm Hollow Modular Anchorage Screw packed with demineralized bone matrix across the SI joint. Post-op care: early mobilization w/in pain limits |
Blood loss: <50 ml No screw loosening, nonunion, or failure LOS: 6.9 days Return to work: 4/9 ODI decreased: 59 to 45 VAS decreased: 8.1 to 4.6 Satisfaction: 6.8 (out of 10) |
1 deep wound infection Complication rate: 11% |
| Wise, 2008 [17] | 13 | Age: 53 years Gender: 12F/1M Follow-up: 29.5 mo Unilateral 7/Bilateral 6 Previous lumbosacral surgery: 8/13 Prior treatments: Failed > 6 mo of conservative therapy |
Relief with SI joint block | 9mm hole drilled through the longitudinal aspect of the SI joint. 2 cages packed with BMP placed across the anterior portion of the SI joint.
Post-op care: limited waist bending, and a sacral belt for 6 mo; full activity at 6 mo |
Blood loss: < 100 ml Length of stay: 1.7 days Fusion rate: 89% Low back VAS improved 4.9 pts Leg VAS improved 2.4 pts |
Reoperation (nonunion): 1 Complication and Revision rate: 8% |
| Buchowski, 2005 [12] | 20 | Age: 45 years Gender: 17F/3M Follow-up: 5.8 yrs Prior treatments: All failed nonoperative treatment Previous spine surgery: 15/20 Symptom Duration: 2.6 yrs Dx: SI joint dysfunction (13), Osteoarthritis (5), Spondyloarthropathy (1), SI joint instability (1) |
Sacral sulcus palpation, positive provocative maneuvers, Pain relief with intraarticular SI joint injections | Modified Smith-Petersen
Incision over posterior 2/3 of iliac crests. Graft stabilized w/ plate and screws. Post-op care: Non-weight bearing for at least 3 months. |
Blood loss: 290 mL Solid fusion: 17 LOS: 5.2 days Return to work: 8/20 SF-36 improved (except GH & MH) AAOS MODEMS sig. improved (except Comorbidity) 60% would have surgery again |
Pseudoarthrosis: 3 Deep wound infection: 2 Painful hardware: 1 Revision surgery (anterior): 3 Complication rate: 30% Revision rate: 15% |
| Giannikas, 2004 [13] | 5 | Age: 22 to 44 years Gender: 3F/2M Follow-up: 29 mo Symptom Duration: 10 to 40 mo Dx: Idiopathic (1), Previous trauma (4) |
SI joint tenderness, positive provocative maneuvers, bone scan, relief with SI joint block | Two bone plugs harvested from the iliac crest and placed through the superior and inferior aspects of the SI Joint.
Post-op care: Non-weight bearing for at least 3 months. |
Complete pain relief: 4/5 Partial pain relief: 1/5 |
None reported |
| Moore, 1997 [15] | 77 | Gender: 48F/29 M Unilateral 74/Bilateral 3 Prior treatments: Failed 6 months of rehab programs Symptom duration: 6 to 84 mo Follow-up: 1 to 5 years Dx: Chronic painful dysfunction |
Relief with SI joint block | Modified Smith-Petersen technique with 15cm incision to reveal the ilium and sacrum. Bone harvested from the ilium and placed in the SI joint after removing the cartilage. 2-3 cannulated screws to lock graft in place. Post-op care: Non-weight bearing for 8 weeks. | 62/77 successful (80.5%) | Superficial wound infection: 1 Post-op radicular pain: 1 Sciatic notch fracture: 1 Pseudoarthrosis: 7 Complication rate: 13% |
| Keating, 1995 [26] | 26 | Age: 38.3 years Follow-up: 16 weeks Prior treatments: Failed 6 weeks of aggressive rehab Symptom duration: 38.3 mo Dx: Chronic LBP |
Relief with SI joint block | Inferior SI joint debrided, decorticated, and packed with bone graft. Secured with 2 lateral compression screws.
Post-op care: 16 week rehabilitation program. |
Pain decreased: 6.1 to 2.9 Work Status increased: 2.3 to 3.3 5 patients returned to work after 16 mo of unemployment |
None reported |
| Waisbrod, 1987 [34] | 21 | Age: 42 Gender: 18F/3M Follow-up: 30 mo Previous spine surgery: 7/21 Symptom duration: > 2 years Dx: SI joint pain |
Tenderness over the SI joint, positive provocative maneuvers, pain provocation w/ NaCL injection, relief w/ SI joint block | SI joint excised and packed w/ iliac crest bone graft and ceramic blocks. Post-op care: Spica cast for 8 weeks. |
11/21 Satisfactory results | Pseudoarthrosis: 2 Infection: 1 Complication rate: 14% |