Skip to main content

Advertisement

SpringerLink
Log in

Impact of diagnosis and type of sacroiliac joint fusion on postoperative complications

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Two main surgical approaches are available for fusing the sacroiliac joint (SIJ): an open or minimally invasive (MIS) approach. The purpose of this study was to analyze the associated total hospital charges and postoperative complications of the MIS and open approach.

Methods

Using the 2016 and 2017 National Readmission Database, we conducted a retrospective cohort analysis of 2521 patients who received a SIJ fusion with an open (N = 1990) or MIS (N = 531) approach for diagnosed sacrum pain, sacroiliitis, sacral instability, or spondylosis. Each cohort was analyzed for postoperative complications.

Results

We identified 604 patients diagnosed with sacrum pain, 1142 with sacroiliitis, 315 with spondylosis, and 288 with sacral instability. Patients who received the open approach for sacrum pain had significantly higher rates of novel post-procedural pain (p = 0.045) and novel lumbar pathology (p = 0.015) within 30 days. On 30-day follow-up, patients with sacroiliitis treated with open SIJ fusion had significantly higher rates of novel postprocedural pain compared to those treated with MIS fusion (p = 0.045). Patients who received the open approach for spondylosis resulted in significantly higher rates of non-elective readmission within 30 days compared to the MIS approach (p < 0.0001). In addition, the open technique for spondylosis resulted in significantly higher rates of non-elective readmissions for infection within 30 days (p = 0.014). On 30-day follow-up, patients with sacral instability treated with open SIJ fusion had significantly higher rates of UTI (p = 0.045).

Conclusion

Our study suggests that there exist unique postoperative complications that arise after SIJ fusion specific to preoperative diagnosis and surgical approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Sembrano JN, Polly DW Jr (2009) How often is low back pain not coming from the back? Spine 34:E27

    Article  Google Scholar 

  2. Andersson GB (1999) Epidemiological features of chronic low-back pain. Lancet 354:581–585

    Article  CAS  Google Scholar 

  3. Weksler N, Velan GJ, Semionov M et al (2007) The role of sacroiliac joint dysfunction in the genesis of low back pain: the obvious is not always right. Arch Orthop Trauma Surg 127:885–888

    Article  Google Scholar 

  4. Foley BS, Buschbacher RM (2006) Sacroiliac joint pain: anatomy, biomechanics, diagnosis, and treatment. Am J Phys Med Rehabil 85:997–1006

    Article  Google Scholar 

  5. Schmidt GL, Bhandutia AK, Altman DT (2018) Management of Sacroiliac Joint Pain. J Am Acad Orthop Surg 26:610–616

    Article  Google Scholar 

  6. Smith-Petersen MN (1921) Arthrodesis of the sacroiliac joint. New Method Approach JBJS 3:400

    Google Scholar 

  7. Rudolf L (2013) MIS fusion of the si joint: does prior lumbar spinal fusion affect patient outcomes? Open Orthop J 7:163–168

    Article  Google Scholar 

  8. Ledonio CG, Polly DW Jr, Swiontkowski MF, Cummings JT Jr (2014) Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion. Med Devices 7:187–193

    Article  Google Scholar 

  9. Miller LE, Reckling WC, Block JE (2013) Analysis of postmarket complaints database for the iFuse SI Joint Fusion System®: a minimally invasive treatment for degenerative sacroiliitis and sacroiliac joint disruption. Med Devices 6:77–84

    Google Scholar 

  10. Ackerman SJ, Polly DW Jr, Knight T et al (2014) Comparison of the costs of nonoperative care to minimally invasive surgery for sacroiliac joint disruption and degenerative sacroiliitis in a United States commercial payer population: potential economic implications of a new minimally invasive technology. Clinicoecon Outcomes Res 6:283–296

    Article  Google Scholar 

  11. Sturesson B, Kools D, Pflugmacher R et al (2017) Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management. Eur Spine J 26:708–719

    Article  Google Scholar 

  12. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    Article  CAS  Google Scholar 

  13. Yson SC, Sembrano JN, Polly DW Jr (2019) Sacroiliac Joint Fusion: Approaches and Recent Outcomes. PM R 11(Suppl 1):S114–S117

    PubMed  Google Scholar 

  14. Zaidi HA, Montoure AJ, Dickman CA (2015) Surgical and clinical efficacy of sacroiliac joint fusion: a systematic review of the literature. J Neurosurg Spine 23:59–66

    Article  Google Scholar 

  15. Lee YC, Lee R, Harman C (2019) The incidence of new onset sacroiliac joint pain following lumbar fusion. J Spine Surg 5:310–314

    Article  Google Scholar 

  16. Colò G, Cavagnaro L, Alessio-Mazzola M et al (2019) Incidence, diagnosis and management of sacroiliitis after spinal surgery: a systematic review of the literature. Musculoskelet Surg. https://doi.org/10.1007/s12306-019-00607-0

    Article  PubMed  Google Scholar 

  17. Ledonio CGT, Polly DW Jr, Swiontkowski MF (2014) Minimally invasive versus open sacroiliac joint fusion: are they similarly safe and effective? Clin Orthop Relat Res 472:1831–1838

    Article  Google Scholar 

  18. Heiney J, Capobianco R, Cher D (2015) A systematic review of minimally invasive sacroiliac joint fusion utilizing a lateral transarticular technique. Int J Spine Surg 9:40

    Article  Google Scholar 

  19. Smith AG, Capobianco R, Cher D et al (2013) Open versus minimally invasive sacroiliac joint fusion: a multi-center comparison of perioperative measures and clinical outcomes. Ann Surg Innov Res 7:14

    Article  Google Scholar 

  20. Shamrock AG, Patel A, Alam M et al (2019) the safety profile of percutaneous minimally invasive sacroiliac joint fusion. Global Spine J 9:874–880

    Article  Google Scholar 

  21. Lingutla KK, Pollock R, Ahuja S (2016) Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis. Eur Spine J 25:1924–1931

    Article  Google Scholar 

Download references

Funding

No funding was received for the current study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Alexander M. Ballatori, Shane Shahrestani, Xiao T. Chen, Andy Ton, Jeffrey C. Wang & Zorica Buser

Authors
  1. Alexander M. Ballatori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shane Shahrestani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiao T. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andy Ton
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jeffrey C. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zorica Buser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Alexander M. Ballatori or Zorica Buser.

Ethics declarations

Conflict of interest

There are no conflicts of interest in this study. Disclosures outside of submitted work: JCW—Royalties—Biomet, Seaspine, Amedica, Synthes; Investments/Options—Bone Biologics, Pearldiver, Electrocore, Surgitech; Board of Directors—AO Foundation, Fellowship Funding (paid to institution): AO Foundation. ZB—consultancy: Cerapedics (past), The Scripps Research Institute (past), Xenco Medical (past), AO Spine (past); Research Support: SeaSpine (past, paid to the institution), Next Science (paid directly to institution), Medical Metrics (past, paid directly to institution); North American Spine Society: committee member; Lumbar Spine Society: Co-chair Educational Committee, AOSpine Knowledge Forum Degenerative: Associate member; AOSNA Research committee- committee member.

Availability of data and material

Not applicable.

Code availability

Not applicable.

Ethics approval

The data source (Healthcare Cost and Utilization Project National Readmission Database) is de-identified, and therefore this study was exempt from institutional review board approval.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ballatori, A.M., Shahrestani, S., Chen, X.T. et al. Impact of diagnosis and type of sacroiliac joint fusion on postoperative complications. Eur Spine J 31, 710–717 (2022). https://doi.org/10.1007/s00586-021-07031-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-021-07031-8

Keywords

Search

Navigation