Distraction arthrodesis of the sacroiliac joint: 2-year results of a descriptive prospective multi-center cohort study in 171 patients

Fuchs, Volker; Ruhl, Benjamin

doi:10.1007/s00586-017-5313-2

Cited by 30 publications

(24 citation statements)

References 38 publications

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“…Among 50 patients who underwent surgery, VAS pain improved from 76.2 to 35.1 (54% reduction, P < .0001); ODI improved from 55.5 to 35.3 ( P < .001). The system utilizes cannulated fully threaded screws and proprietary decortication instruments that allow a limited amount of decortication and bone grafting . Two‐year results are still pending.…”

Section: Discussionmentioning

confidence: 99%

“…This study was supported by another implant company (SIGNUS, Alzenau, Germany). 17 The findings from the aforementioned trials are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…The system utilizes cannulated fully threaded screws and proprietary decortication instruments that allow a limited amount of decortication and bone grafting. 17 Two-year results are still pending.…”

Section: Discussionmentioning

confidence: 99%

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Sacroiliac Joint Fusion: Approaches and Recent Outcomes

Yson

Sembrano

Polly

2019

PM&R

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The sacroiliac joint may be a primary source of pain in patients complaining of low back and/or buttock pain. Nonsurgical treatment of sacroiliac joint pain typically includes structured core and pelvic muscle flexibility and strengthening; pharmaceutical management through oral and injectable medication; and ablation procedures. For patients who do not improve with comprehensive, nonoperative treatment, surgical fusion of the sacroiliac joint is an option with overall good reported outcomes and high patient satisfaction. Minimally invasive surgery (MIS) approaches have been shown to have lower morbidity and earlier recovery than traditional open approaches. To date, the majority of published clinical studies on MIS sacroiliac joint fusion are industry‐sponsored and predominantly using one system (ingrowth triangular titanium rods). These include two level 1 randomized controlled trials comparing MIS sacroiliac joint fusion to nonoperative management, with results favoring surgery.

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Section: Discussionmentioning

confidence: 99%

“…This study was supported by another implant company (SIGNUS, Alzenau, Germany). 17 The findings from the aforementioned trials are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

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Sacroiliac Joint Fusion: Approaches and Recent Outcomes

Yson

Sembrano

Polly

2019

PM&R

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“…One patient was revised to an open arthrodesis secondary to nonunion and persistent pain. 18 Fuchs and Ruhl, 19 in a level 2 prospective observational study, reported on 171 patients who underwent distraction arthrodesis using the DIANA cage. The study involved 20 hospitals in Germany.…”

Section: Dorsal Approachmentioning

confidence: 99%

Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence

et al. 2020

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Background: Fusion of the sacroiliac (SI) joint as a treatment for low back pain remains controversial. The purpose of this manuscript is to review the current literature and clinical outcomes of SI joint fusion surgery. Methods: We conducted a literature review and included studies with the term ''sacroiliac joint fusion'' that had at least 12 months of clinical follow-up, reported on minimally invasive techniques, and included patient-reported outcome measures. Results: Two approach types (dorsal and lateral) and numerous different implant manufacturers were identified. Most studies included level 4 data, with a small number of level 2 prospective cohort studies and 2 prospective level 1 studies. Every reviewed study reported clinical benefit in terms of improved pain scores or improvement in validated disability measures. Complication rates were low. Conclusions: Minimally invasive SI joint fusion provides clinically significant improvement in pain scores and disability in most patients, across multiple studies and implant manufacturers. Level of Evidence: 5 Clinical Relevance: Emerging evidence in support of SI joint fusion indicates that clinicians should examine the SI joint and include SI joint pain in their differential diagnosis for low back pain patients.

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“…In addition to the anterior approach to the SIJ which is accompanied by many complications [3,8], the dorsal approach via the recess of the SIJ seems more promising with regard to the possibility of an arthrodesis of the sacroiliac joint [9]. In this procedure, the interosseous ligaments between the sacrum and ilium, which have already become degeneratively altered and insufficient in the course of arthrosis of the SIJ, are resected [10].…”

Section: Introductionmentioning

confidence: 99%

A novel arthrodesis technique of the sacroiliac joint

Fuchs¹

2019

Preprint

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Purpose The aim of the study was to develop an implant for fusion of the sacroiliac joint (SIJ) which, in contrast to known implant systems, can be used for isolated fusion of the SIJ as well as in combination with a lumbar instrumentation procedure or as an alternative to existing sacropelvic fixation (SPF) methods. Methods Following a comprehensive review of more than 200 high-resolution pelvic CT data sets, an implant body with high porosity and a large contact surface to the ilium and sacrum favoring integration was designed. Its shape was modeled based on the recess of the SIJ. A screw anchored in the ilium secures the position of the implant in the recess and allows connection to a lumbar instrumentation via an S1 screw. After receiving a detailed explanation and information about the novelty of the procedure, two patients with confirmed SIJ syndrome, who had undergone conservative treatment for more than 6 months without success, were operated on with a patient individual implant adapted to their anatomy. Results There were no intraoperative or postoperative complications. The postoperative CT and pelvic X-rays showed a good form fit of the implant body in the respective recess as well as correct positioning of the inserted screws. Conclusions The implant used first takes into account the special anatomy of the SIJ and also meets the requirements of a true arthrodesis of the joint. Clinical studies will now have to show whether the considerable theoretical advantages of the new implant system over existing SIJ implants and SPFs can be put into practice.

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Distraction arthrodesis of the sacroiliac joint: 2-year results of a descriptive prospective multi-center cohort study in 171 patients

Cited by 30 publications

References 38 publications

Sacroiliac Joint Fusion: Approaches and Recent Outcomes

Sacroiliac Joint Fusion: Approaches and Recent Outcomes

Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence

A novel arthrodesis technique of the sacroiliac joint

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