Postoperative complications in patients undergoing minimally invasive sacroiliac fusion

Schoell, Kyle; Buser, Zorica; Jakoi, Andre; Pham, Martin H.; Patel, Neil N.; Hsieh, Patrick C.; Liu, John C.; Wang, Jeffrey C.

doi:10.1016/j.spinee.2016.06.016

Cited by 31 publications

(25 citation statements)

References 29 publications

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“…Similarly, nerve ablation techniques 70 – 75 and surgical interventions using both open 76 – 78 and minimally-invasive approaches 55 – 58 , 79 have yielded promising results concerning patient outcomes 80 . However, comparative studies between the surgery and non-surgery groups found little advantage in long-term follow-up 81 , and surgery was accompanied by significant complication rates, especially infections 82 , 83 and non-unions 84 . Here, pelvic orthoses appear to have certain advantages over invasive procedures.…”

Section: Discussionmentioning

confidence: 99%

Pelvic orthosis effects on posterior pelvis kinematics An in-vitro biomechanical study

Klima

Grunert

Ondruschka

et al. 2018

Sci Rep

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The sacroiliac joint (SIJ) is a well-known source of low back pain, with increasing interest for both conservative and surgical treatment. Alterations in pelvis kinematics are hypothesized as a contributor to SIJ pain and pelvic orthoses one treatment option, but their effects on the pelvis are poorly understood. Alterations in movement patterns induced by the application of pelvic orthoses were determined in five human cadaveric pelvises. Deformations were obtained from the lumbosacral transition and the bilateral SIJ, using digital image correlation and a customized routine to compute the movements within the pelvis. Significant alterations were found for the movements at the SIJ, in particular a vast increase in axial (x-axis) rotation, accompanied by increased inferior (y-) translation of the sacrum relative to the ilium. Movement patterns at the lumbosacral transition changed, causing increases in axial rotation and decreased inferior translation of L5 relative to S1. Using a physiologic mode of load application gives novel insights into the potential effects of pelvic orthoses. The results of these in-vitro experiments vary markedly from previous experiments with loading limited to two or less axes. Furthermore, the influence of pelvic orthoses on the lumbosacral transition warrants further investigation.

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Section: Discussionmentioning

confidence: 99%

Pelvic orthosis effects on posterior pelvis kinematics An in-vitro biomechanical study

Klima

Grunert

Ondruschka

et al. 2018

Sci Rep

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“…This has been explored by previous authors, but to our knowledge no data is available comparing fluoroscopic versus CT -based techniques. Schoell et al 18 performed the largest evaluation of safety for SI fusion, reporting complication rates in a minimally-invasive SI joint fusion patient population. They used CPT and ICD-9 codes to identify primary (non-revision) minimally invasive SI fusion procedures in a large nationwide insurance database.…”

Section: Discussionmentioning

confidence: 99%

“…Complications such as pseudarthrosis and neural injuries, while rare, are often associated with need for revision surgery and poorer outcome. 18,19 The transition to CT-based image-guidance aims to reduce such complications. The purpose of this study is to review our series of minimally invasive sacroiliac fusion with a focus on safety and complications, and to review differences in these parameters between patients undergoing fluoroscopic technique versus CT-based image-guidance.…”

Section: Introductionmentioning

confidence: 99%

Sacroiliac Joint Fusion – Impact of a New Image-Guidance Protocol on Safety and Complications

2019

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“…Both the Medicare database and Humana database have been used in numerous publications. [13][14][15] These databases are compliant with all regulations associated with the Health Insurance Portability and Accountability Act, as all patient identifiers were removed from the clinical/financial data. No Institutional Review Board authorization was required to conduct this study.…”

Section: Methodsmentioning

confidence: 99%

Factors Affecting Utilization of Steroid Injections in the Treatment of Lumbosacral Degenerative Conditions in the United States

2018

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Background: Lumbar degenerative conditions are an extremely common set of diagnoses with a large spectrum of treatment options. Epidural steroid injections (ESI) are widely used but have come under increased scrutiny as we move toward a value-based model of health care. We assessed current utilization of epidural steroid injections, changes in utilization over time, and the influence of payer type and geographic region within the United States on their utilization. In addition, we analyzed the relationship between ESIs and surgical rates across states. Methods: The Medicare 5% national sample administrative database (SAF5) and a large national database from a commercial health care company (HORTHO) were used to catalog clinical data for patients with lumbar degenerative conditions. Specific queries into the rate of ESIs and lumbar surgery were also performed within this group. Results: There were 4 108 121 patients found between 2005 and 2015 in the SAF5 and HORTHO databases carrying a diagnosis related to lumbar degenerative conditions. The overall yearly injection rates for patients with lumbar degenerative conditions ranged from 9.84% to 10.18%. In patients older than 65, the rate of ESI was higher for Medicare as compared with private payer insurance (16.27% versus 14.14%, P , .001). There was a higher rate of ESI for patients who eventually underwent surgery in the Medicare group as compared with the commercial group (55.30% versus 40.40%, P , .001). There was a positive correlation between rates of ESI with the rate of surgery between states. Conclusions: There is considerable variation in treatment of lumbar degenerative conditions with ESI based on payer type. There was increased utilization of lumbar ESI between 2007 and 2012, although this change was less than 0.5%. The data also suggest a positive correlation between rates of ESIs and surgical intervention across states. This points to areas in the country with high utilization of both ESI and surgery in the treatment of lumbar degenerative conditions.

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Postoperative complications in patients undergoing minimally invasive sacroiliac fusion

Cited by 31 publications

References 29 publications

Pelvic orthosis effects on posterior pelvis kinematics An in-vitro biomechanical study

Pelvic orthosis effects on posterior pelvis kinematics An in-vitro biomechanical study

Sacroiliac Joint Fusion – Impact of a New Image-Guidance Protocol on Safety and Complications

Factors Affecting Utilization of Steroid Injections in the Treatment of Lumbosacral Degenerative Conditions in the United States

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