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Sacroiliac joint fusion likely more effective than nonsurgical care at 1 year
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Researchers of this level 1 study found patients with sacroiliac joint dysfunction caused by degeneration or disruption benefited more from minimally invasive sacroiliac joint fusion surgery than nonsurgical management at 1-year follow-up.
Using the Investigation of Sacroiliac Fusion Treatment (INSITE) ongoing controlled trial, researchers evaluated 148 patients with sacroiliac joint (SIJ) dysfunction who were randomly assigned to either minimally invasive SIJ fusion with triangular titanium implants (102 patients) or nonsurgical management (46 patients). Researchers compared disability, pain and quality of life scores at 1-month, 3-months, 6-months and 12-months follow-up between the cohorts.
Researchers found 6-month success rates were highest in patients who underwent surgery, with 81.4% meeting the primary success end point of the study compared with 26.1% of nonsurgical patients. One patient in the fusion group failed at the 6-month primary end point for inadequate pain reduction and required revision for symptomatic implant malposition. There were no failures in the nonsurgical group.
Patients in the fusion group had a mean pain improvement score of 52 points (82.3 points at baseline and 30.4 points at 6-month follow-up), researchers wrote.
David W. Polly
A total of 44 nonsurgical management patients crossed over to the surgical group. All crossover patients had improved Oswestry Disability Index scores, pain scores, disability scores and quality of life similar to those in the surgical group.
Researchers concluded minimally invasive SIJ fusion with triangular titanium implants is more effective at improving pain, function and quality of life at 1-year follow-up compared with nonsurgical management. – by Robert Linnehan
Disclosure: All researchers conduct clinical research for SI-BONE and the study was sponsored by SI-BONE (San Jose, Calif.). Polly reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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