Minimally Invasive Sacroiliac Joint Fusion Using a Novel Hydroxyapatite-Coated Screw: Preliminary 1-Year Clinical and Radiographic Results of a 2-Year Prospective Study

World Neurosurg. 2017 May:101:493-497. doi: 10.1016/j.wneu.2017.02.046. Epub 2017 Feb 16.

Abstract

Objective: Proper diagnosis and treatment of sacroiliac joint (SIJ) pain remains a clinical challenge. Dysfunction of the SIJ can produce pain in the lower back, buttocks, and extremities. Triangular titanium implants for minimally invasive surgical arthrodesis have been available for several years, with reputed high levels of success and patient satisfaction. This study reports on a novel hydroxyapatite-coated screw for surgical treatment of SIJ pain.

Methods: Data were prospectively collected on 32 consecutive patients who underwent minimally invasive SIJ fusion with a novel hydroxyapatite-coated screw. Clinical assessments and radiographs were collected and evaluated at 3, 6, and 12 months postoperatively.

Results: Mean (standard deviation) patient age was 55.2 ± 10.7 years, and 62.5% were female. More patients (53.1%) underwent left versus right SIJ treatment, mean operative time was 42.6 ± 20.4 minutes, and estimated blood loss did not exceed 50 mL. Overnight hospital stay was required for 84% of patients, and the remaining patients needed a 2-day stay (16%). Mean preoperative visual analog scale back and leg pain scores decreased significantly by 12 months postoperatively (P < 0.01). Mechanical stability was achieved in 93.3% (28/30) of patients, and all patients who were employed preoperatively returned to work within 3 months. Two patients who required revision surgery reported symptom improvement within 3 weeks and did not require subsequent surgery.

Conclusions: Positive clinical outcomes are reported 1 year postoperatively after implantation of a novel implant to treat sacroiliac joint pain. Future clinical studies with larger samples are warranted to assess long-term patient outcomes.

Keywords: SI joint fusion; Sacroiliac joint; Sacroiliac joint dysfunction.

MeSH terms

  • Aged
  • Bone Screws / statistics & numerical data
  • Bone Screws / trends*
  • Durapatite / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Minimally Invasive Surgical Procedures / trends*
  • Prospective Studies
  • Sacroiliac Joint / diagnostic imaging*
  • Sacroiliac Joint / surgery*
  • Spinal Fusion / methods
  • Spinal Fusion / trends*
  • Time Factors

Substances

  • Durapatite