Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis

Lingutla, Kiran; Pollock, Raymond; Ahuja, Sashin

doi:10.1007/s00586-016-4490-8

Cited by 55 publications

(36 citation statements)

References 25 publications

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“…Our findings both replicate and extend previous studies. In previously published case series [36][37][38][39], systematic reviews [40,41], a prospective multicenter clinical trial [42], and a recently published randomized clinical trial of similar design conducted in the USA [43], similar improvements in SIJ pain, self-rated limitations in activities due to pain (Oswestry Disability Index) and quality of life were observed in participants undergoing SIJF. Our study provides an additional, independent confirmation that the improvements after surgery are clinically important and statistically superior to those seen with continued conservative care.…”

Section: Discussionmentioning

confidence: 89%

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

et al. 2016

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Purpose To compare the safety and effectiveness of minimally invasive sacroiliac joint fusion (SIJF) using triangular titanium implants vs conservative management (CM) in patients with chronic sacroiliac joint (SIJ) pain. Methods 103 adults with chronic SIJ pain at nine sites in four European countries were randomly assigned to and underwent either minimally invasive SIJF using triangular titanium implants (N = 52) or CM (N = 51). CM was performed according to the European guidelines for the diagnosis and management of pelvic girdle pain and consisted of optimization of medical therapy, individualized physical therapy (PT) and adequate information and reassurance as part of a multifactorial treatment. The primary outcome was the difference in change in self-rated low back pain (LBP) at 6 months. Additional endpoints included quality of life using EQ-5D-3L, disability using Oswestry Disability Index (ODI), SIJ function using active straight leg raise (ASLR) test and adverse events. NCT01741025. Results At 6 months, mean LBP improved by 43.3 points in the SIJF group and 5.7 points in the CM group (difference of 38.1 points, p \ 0.0001). Mean ODI improved by 26 points in the SIJF group and 6 points in the CM group (p \ 0.0001). ASLR, EQ-5D-3L, walking distance and satisfaction were statistically superior in the SIJF group. The frequency of adverse events did not differ between groups. One case of postoperative nerve impingement occurred in the surgical group. Conclusions In patients with chronic SIJ pain, minimally invasive SIJF using triangular titanium implants was safe and more effective than CM in relieving pain, reducing disability, improving patient function and quality of life.

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Section: Discussionmentioning

confidence: 89%

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

et al. 2016

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“…48 The NHLBI tool has 14 items which are used in previous systematic reviews of observational studies. 49,50 Each item is assessed through a question where the possible answers are yes, no, or other (cannot determine, not applicable, or not reported). The NHLBI tool enables to score and weigh the evidence to rate the overall quality of each study as 'good', 'fair', or 'poor' indicating the validity of the findings in the respective study.…”

Section: Quality Assessment Of the Included Studiesmentioning

confidence: 99%

Prevalence, Characteristics, and Associated Factors of Workplace Violence Against Healthcare Professionals in India: A Systematic Review and Meta-analysis

Hossain

Sharma

Tasnim

et al. 2020

Preprint

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Background: Workplace violence (WPV) against doctors, nurses, and other healthcare professionals is a growing public health concern affecting health systems in low- and middle-income countries. In India, incidents of WPV against health workforce have become common in recent years. However, there is no synthesized evidence on the nationwide burden of WPV in healthcare. This study aims to systematically evaluate the current evidence on the prevalence, characteristics, and associated factors of WPV against healthcare professionals in India. Methods: We systematically searched seven major databases and additional sources to retrieved published literature on WPV in India. We included empirical studies without any time restriction, which reported the prevalence of WPV against healthcare professionals in India. Following data extraction, we estimated the pooled prevalence of WPV using random-effects model in meta-analysis. The characteristics and associated factors of WPV were narratively synthesized from these empirical studies. Results: Among 1065 articles retrieved from multiple sources, 15 studies met our inclusion and exclusion criteria. The pooled prevalence of WPV among 2849 participants in those 15 studies was 63% (95% confidence interval [CI], 54%-72%). In the subgroup analyses, the pooled prevalence for male and female was 64% (95% CI, 51%-78%) and 54% (95% CI, 47%-62%) respectively. Moreover, pooled prevalence in 12-months and lifetime was 55% (95% CI, 43%-67%) and 69% (95% CI, 61%-78%) respectively. Among the participants, the prevalence of verbal violence (52%; 95% CI, 45%-60%) was higher than physical violence (8%; 95% CI, 5%-11%). The emergency department was a common location of WPV, whereas the patients' attendants were perpetrators in most studies. Major factors associated with WPV included ineffective patient-provider communication, less experience of the healthcare professionals, overcrowding, shortage of resources, long waiting hours, lack of security measures, dissatisfaction about health services, high cost of care, the negative role of media, and other socio-behavioral problems among the patients and healthcare professionals. Conclusion: WPV is highly prevalent among healthcare professionals in India. Critical challenges within the healthcare and social context necessitate further research, better policymaking, and multipronged interventions to address the same and prevent WPV against healthcare professionals in India.

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“…In patients who have failed conservative management in the way of nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, pelvic belt stabilization, and in whom image guided joint injections have demonstrated a positive response, operative treatment with minimally invasive arthrodesis may be a definitive solution. Several studies have shown excellent functional outcomes and resolution of symptoms, however many of them are vendor sponsored with potential for conflicts of interest [ 2 3 7 14 19 20 21 22 ]. We hypothesize that a less invasive SIJ fusion technique may lead to favorable clinical outcomes with minimal associated surgical morbidity provided all other reasons for back pain have been adequately ruled out.…”

Section: Introductionmentioning

confidence: 99%

Patient Reported Outcomes from Sacroiliac Joint Fusion

Kancherla¹,

McGowan²,

Audley³

et al. 2017

Asian Spine J

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Study DesignRetrospective, case series.PurposeThe purpose of this study is to determine morbidity, complications, and patient reported outcomes from minimally invasive sacroiliac joint (SIJ) fusion.Overview of LiteratureLumbar back pain emanating from the SIJ can be surgically treated via a percutaneous approach in the appropriately selected patient with minimal morbidity and acceptable functional outcomes.MethodsPatients diagnosed by >2 physical examination maneuvers and subjective relief from a computed tomography–guided lidocaine-bupivacaine-steroid injection underwent SIJ fusion after failing conservative management with a combination of oral anti-inflammatory medications, physical therapy, and pelvic belt stabilization. Perioperative data collected include estimated blood loss (EBL) and operative time. Oswestry disability index, 12-item short form health survey (SF-12), visual analogue score, and functional status were analyzed. All complications were noted.ResultsThe study cohort of 45 cases (69% female) achieved postoperative survey follow-up at 9.9 and 32.3 months. SF-12 physical component summary statistically improved while all other scores were equivalent. Mean EBL and operative time were 22 mL and 36 minutes, respectively. Initial survey showed that 64% of patients discontinued narcotics (29/45), 71% do not use an assistive device (32/45), and 15.6% do not work due to pain (7/45). 73% of patients stated they would have the surgery again (33/45). For the second survey, 65% of patients discontinued narcotics (26/40), 70% did not use an assistive device (28/40), and 17.5% did not work due to pain (7/40). A history of thoracolumbar instrumentation (16/45) did not significantly affect outcomes. Three complications described by screw malposition with neurologic deficit (6.7%) were treated with screw repositioning (1 case) and removal of a single superior implant (2 cases) with time to revision of 2.2 months. All three ultimately had resolution of radicular pain.ConclusionsPercutaneous SIJ fusion offers minimal morbidity and acceptable functional outcomes. While women and those with a prior history of lumbar instrumentation may be at increased risk of having SIJ dysfunction requiring surgical intervention, it was not found to affect postoperative functional outcomes when compared to the non-instrumented group.

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Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis

Abstract: SIJF appears to be a satisfactory procedure for alleviating pelvic girdle pain.

Cited by 55 publications

References 25 publications

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

Prevalence, Characteristics, and Associated Factors of Workplace Violence Against Healthcare Professionals in India: A Systematic Review and Meta-analysis

Patient Reported Outcomes from Sacroiliac Joint Fusion

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