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Minimally invasive fusion can provide better outcomes than non-surgical management for SI pain

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CHICAGO — For patients with chronic sacroiliac joint pain or sacroiliitis, minimally invasive surgical options offered significantly improved pain and function scores compared with non-surgical options, a speaker said here.

David W. Polly, MD, said patients who opted for a minimally invasive sacroiliac (SI) joint fusion with a triangular titanium implant experienced improvements in several outcome categories compared with patients who underwent non-surgical management.

“Minimally invasive sacroiliac joint fusion was better for pain, disability and quality of life in patients and had an acceptable safety profile,” Polly said at the Lumbar Spine Research Society Annual Meeting.

The multicenter, prospective study conducted by Polly and colleagues included 148 patients with SI joint pain who were randomly assigned to receive either minimally invasive SI joint fusion (102 patients) or nonsurgical management (46 patients). Quality-of-life scores, SF-36 and EuroQol-5D responses were collected at baseline and again at the 6-month follow-up.

At baseline, the patients had average VAS and Oswestry Disability Index (ODI) scores of 82 points and 62points, respectively, according to Polly. The patients were highly debilitated and, on average, had been experiencing pain for 6 years, he said.

A 20-point improvement of pain was considered a success, and patients in the fusion group had an average 42-point improvement. By 6 months, success in the fusion group was reached in 81% of patients, according to Polly, and in 27.5% of patients in the nonsurgical management group (P < .0001).

For ODI scores, 48.6% of fusion patients had an improvement of 15 points or more compared with 11.4% of nonsurgical management patients.

In terms of safety, no statistically significant difference was observed in adverse events between the groups, according to Polly. – by Robert Linnehan

Reference:

Polly DW, et al. Paper #6. Presented at: Lumbar Spine Research Society Annual Meeting. April 9-10, 2015; Chicago.

Disclosure: Polly reports no relevant financial disclosures.