gms | German Medical Science

Objective: The SIJ is a common cause of Low Back Pain (LBP), which not only generates a reduction in quality of life, but also disabilities in daily life. Current conservative treatments are very often unsatisfactory. Because of a currently ongoing prospective study showing that the iFuse Implant System after 12 months having better effect than non-surgical management regarding to pain relief in SIJ syndrome patients¹. We want to present our first results.

Method: In period from May to November 2015 4 patients with SIJ syndrome have been treated surgically in our department after failure of conservative management with a minimally invasive transarticular arthrodesis of one or both sacroiliac joints with triangular, bolt-shaped and porous-coated titanium implants. All patients had received conservative therapy preoperatively, which usually includes options such as pain medication, physiotherapy, manual therapy and therapeutic infiltrations.

Results: We included one female patient 76-year-old with a left sided SIJ syndrome as well as 3 male patients 74, 55 and 60 years old, all suffered from a bilateral SIJ syndrome for more than 6 mo. All patients had been received diagnostic injection before surgery and 2 out of 4 patients had prior lumbar fusion surgery. After failed conservative therapy the VAS values were between min. 5 and max. 9 pts. In the intervention, all patients got min. 2 implants (1 pat.) or 3 implants (3 pat.) per each SIJ. Mean duration of surgery in 6 interventions were 88 minutes, 2 patients received bilateral SIJ Fusion at different times and the length of hospital stay was 4.7 days in average. Postoperatively, we documented average reduction in VAS by 4.9 pts. All patients were mobilized after surgery in the same day and were instructed to partial weight bearing with forearm crutches for 3 weeks, but all could easily mobilize self-dependently. No intra- or postoperative complications were observed.

Conclusions: Our results suggest that SIJ arthrodesis with iFuse represents an initial satisfactory therapy option after failed conservative treatment for SIJ syndromes and also result in a significant reduction in pain postoperatively. A further observation and follow-up of our patients is ongoing.