"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

Margaret Mead
Original article
peer-reviewed

A Retrospective Outcomes Study of 20 Sacroiliac Joint Fusion Patients



Abstract

Study Design

Retrospective case series.

Purpose

To report a novel approach to open posterior sacroiliac (SI) joint arthrodesis using a threaded titanium cage containing rhBMP­-2.

Materials & Methods

Twenty consecutive patients with a mean age of 57.7 years (range: 33­-84) underwent posterior SI joint fusion. Two closely related novel posterior oblique approaches were employed. Enrolled subjects included 17 females and three males. The mean follow­-up time for CT to assess fusion was 27 months (range: 17­-45 months). Insurance included a mixture of public and private payers. One of the patients (patient 19) was on worker’s compensation. During follow-­up, patients were assessed radiologically for radiographic bony union and asked to rate their satisfaction with the procedure. The Oswestry Disability Index (ODI) was applied on a one-time basis upon follow-up. All patients were diagnosed with sacroiliac joint pain based primarily on a positive response to fluoroscopically guided injections into the sacroiliac joint.

Results

Out of 20 patients, 33 SI joints were considered symptomatic and operated, and 32/33 joints successfully fused radiographically (a 96.9% fusion success rate). The average procedure satisfaction rating (PSR) was 7.25 out of a maximum 10 (range 1­-10). Seventeen patients responded to post-surgery ­follow-up questions, and 13 patients (76%), indicated they would elect to have the surgery again as well as recommend it to others. Average estimated blood loss was less than 50 mL, and average length of stay was one day.

Conclusions

Preliminary experiences with these novel posterior approaches to the SI joint described here seem to be safe and effective. The novel posterior approaches to the SI joint described here appear, preliminarily, to have many advantages over previously described procedures including markedly reduced surgical morbidity.



Want to read more?

Create a free account to continue reading this article.

Already a member? Login.



Original article
peer-reviewed

A Retrospective Outcomes Study of 20 Sacroiliac Joint Fusion Patients


Author Information

Carter E. Beck

Montana Neuroscience Institute

Saskia Jacobson

Montana Neuroscience Institute

Eamon Thomasson Corresponding Author

Biomedical Engineering, Columbia University


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. St. Patrick Hospital/Community Medical Center Joint IRB issued approval N/A. The St. Patrick Hospital/Community Medical Center Joint IRB reviewed and approved the above-referenced research study on January 7, 2014 and continued oversight of the study until it was officially closed out on 11/14/2014.

Larger IRBs assign protocol numbers (file numbers) specific for their IRB reference. However, since this is a small IRB, we do not assign protocol or file numbers to research studies. Large, sponsored studies usually have a protocol number associated to the study. The sponsor gives them the protocol number (not the IRB). Because this study is an investigator-initiated study, there would not be a number associated with the study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Carter Beck,
Saskia Jacobson declare(s) personal fees, employment and a patent from Medtronic. Carter Beck, the primary investigator, is involved in a consulting and product development capacity with Medtronic, Inc. Saskia Jacobson is currently an employee of Medtronic, Inc. This work represents the contributions of Saskia Jacobson prior to employment with Medtronic, Inc. No funds were received from Medtronic Corp for this research. Intellectual property info: Dr. Carter Beck has a patent pending under his name, the rights to which are held by Medtronic, Inc. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Acknowledgements

We would like to thank Dr. Leonid Kalachev, Chair of Mathematical Sciences Department, University of Montana, for providing assistance with the statistical analysis.


Original article
peer-reviewed

A Retrospective Outcomes Study of 20 Sacroiliac Joint Fusion Patients


Figures etc.

Share
Original article
peer-reviewed

A Retrospective Outcomes Study of 20 Sacroiliac Joint Fusion Patients

Carter E. Beck">Carter E. Beck, Saskia Jacobson">Saskia Jacobson, Eamon Thomasson">Eamon Thomasson

  • Author Information
    Carter E. Beck

    Montana Neuroscience Institute

    Saskia Jacobson

    Montana Neuroscience Institute

    Eamon Thomasson Corresponding Author

    Biomedical Engineering, Columbia University


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. St. Patrick Hospital/Community Medical Center Joint IRB issued approval N/A. The St. Patrick Hospital/Community Medical Center Joint IRB reviewed and approved the above-referenced research study on January 7, 2014 and continued oversight of the study until it was officially closed out on 11/14/2014.

    Larger IRBs assign protocol numbers (file numbers) specific for their IRB reference. However, since this is a small IRB, we do not assign protocol or file numbers to research studies. Large, sponsored studies usually have a protocol number associated to the study. The sponsor gives them the protocol number (not the IRB). Because this study is an investigator-initiated study, there would not be a number associated with the study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Carter Beck,
    Saskia Jacobson declare(s) personal fees, employment and a patent from Medtronic. Carter Beck, the primary investigator, is involved in a consulting and product development capacity with Medtronic, Inc. Saskia Jacobson is currently an employee of Medtronic, Inc. This work represents the contributions of Saskia Jacobson prior to employment with Medtronic, Inc. No funds were received from Medtronic Corp for this research. Intellectual property info: Dr. Carter Beck has a patent pending under his name, the rights to which are held by Medtronic, Inc. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements

    We would like to thank Dr. Leonid Kalachev, Chair of Mathematical Sciences Department, University of Montana, for providing assistance with the statistical analysis.


    Article Information

    Published: April 01, 2015

    DOI

    10.7759/cureus.260

    Cite this article as:

    Beck C E, Jacobson S, Thomasson E (April 01, 2015) A Retrospective Outcomes Study of 20 Sacroiliac Joint Fusion Patients. Cureus 7(4): e260. doi:10.7759/cureus.260

    Publication history

    Received by Cureus: January 16, 2015
    Peer review began: January 21, 2015
    Peer review concluded: March 17, 2015
    Published: April 01, 2015

    Copyright

    © Copyright 2015
    Beck et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Study Design

Retrospective case series.

Purpose

To report a novel approach to open posterior sacroiliac (SI) joint arthrodesis using a threaded titanium cage containing rhBMP­-2.

Materials & Methods

Twenty consecutive patients with a mean age of 57.7 years (range: 33­-84) underwent posterior SI joint fusion. Two closely related novel posterior oblique approaches were employed. Enrolled subjects included 17 females and three males. The mean follow­-up time for CT to assess fusion was 27 months (range: 17­-45 months). Insurance included a mixture of public and private payers. One of the patients (patient 19) was on worker’s compensation. During follow-­up, patients were assessed radiologically for radiographic bony union and asked to rate their satisfaction with the procedure. The Oswestry Disability Index (ODI) was applied on a one-time basis upon follow-up. All patients were diagnosed with sacroiliac joint pain based primarily on a positive response to fluoroscopically guided injections into the sacroiliac joint.

Results

Out of 20 patients, 33 SI joints were considered symptomatic and operated, and 32/33 joints successfully fused radiographically (a 96.9% fusion success rate). The average procedure satisfaction rating (PSR) was 7.25 out of a maximum 10 (range 1­-10). Seventeen patients responded to post-surgery ­follow-up questions, and 13 patients (76%), indicated they would elect to have the surgery again as well as recommend it to others. Average estimated blood loss was less than 50 mL, and average length of stay was one day.

Conclusions

Preliminary experiences with these novel posterior approaches to the SI joint described here seem to be safe and effective. The novel posterior approaches to the SI joint described here appear, preliminarily, to have many advantages over previously described procedures including markedly reduced surgical morbidity.



Want to read more?

Create a free account to continue reading this article.

Already a member? Login.



Carter E. Beck, M.D.

Montana Neuroscience Institute

Saskia Jacobson

Montana Neuroscience Institute

Eamon Thomasson, Medical Student

Biomedical Engineering, Columbia University

For correspondence:
est2119@columbia.edu

Carter E. Beck, M.D.

Montana Neuroscience Institute

Saskia Jacobson

Montana Neuroscience Institute

Eamon Thomasson, Medical Student

Biomedical Engineering, Columbia University

For correspondence:
est2119@columbia.edu