Novel Interventional Techniques for Chronic Pain with Minimally Invasive Arthrodesis of the Sacroiliac Joint: (INSITE, iFuse, Tricor, Rialto, and others)

Abstract

Acute and chronic pain are public health issues that clinicians have been battling for years. Opioid medications have been a treatment option for both chronic and acute pain; however, they can cause unwanted complications and are a major contributor to our present opioid epidemic. The sacroiliac (SI) joint is a common cause of both acute and chronic low back pain. It affects about 15-25% of patients with axial low back pain, and up to 40% of patients with ongoing pain following lumbar fusion. Recent advances in the treatment of SI joint pain have led to the development of a wide variety of SI joint fusion devices. These fusion devices seek to stabilize the joints themselves in order that they become immobile and, in theory, can no longer be a source for pain. This is a minimally invasive procedure aimed to address chronic pain without subjecting patients to lengthy surgery or medications, including opioids with the potential for addiction and abuse. Minimally invasive SI fusion can be performed by a lateral approach (i.e., iFuse, Tricor) or posterior approach (i.e., CornerLoc, LinQ,

Advances in Pain Medicine: a Review of New Technologies

“…SIJ dysfunction has been identified as a common, yet underdiagnosed cause of acute and chronic low back pain [67][68][69]. Over the last decade, SIJ fusion techniques have gained popularity owing to recent advances in the minimally invasive surgical techniques [70] and have been seen as an alternative to opioid medications for pain management [71]. SIJ fusion procedures have increased in tandem with approval of these devices by the FDA.…”

“…Table 3 lists these devices along with the favored surgical approach and their compatibility with the grafts [72]. SIJ fusion is most commonly achieved through the lateral approach [72] by placing the device through the ilium into sacrum, thus bridging the joint [71]. This approach has been associated with a more stable fusion, minimal complications, and statistically significant improvements in patient reported outcomes [72][73][74].…”

“…The less common posterolateral approach involves accessing the sacroiliac joint from the posterior inferior iliac spine in an anteroinferior direction [72], while the posterior allograft approach involves placing the allograft bone products or devices into the ligamentous component of sacroiliac joint. This allografting technique involves minimal soft tissue destruction and requires only half a day of hospitalization [71].…”

Salvage of Failed Lateral Sacroiliac Joint Fusion with a Novel Posterior Sacroiliac Fusion Device: Diagnostic Approach, Surgical Technique, and Multicenter Case Series

“… 6 Over the past decade the minimally invasive lateral fusion has become increasingly more popular focusing on improved VAS and ODI scores, reduced operative times, blood loss, complications and shorter hospital stays. 1 , 2 , 7 Lateral fusion is performed using the transiliac approach by placing 1–3 implants across the joint to fix the sacroiliac joint for long-term arthrodesis. 7 , 8 …”

“… 1 , 2 , 7 Lateral fusion is performed using the transiliac approach by placing 1–3 implants across the joint to fix the sacroiliac joint for long-term arthrodesis. 7 , 8 …”