European Spine Journal

, Volume 22, Issue 10, pp 2325–2331 | Cite as

The percutaneous stabilisation of the sacroiliac joint with hollow modular anchorage screws: a prospective outcome study

Original Article

Abstract

Purpose

The use of percutaneous iliosacral screw fixation as a treatment of sacroiliac joint pain has been reported to be successful. This study was a prospective single surgeon series to evaluate the short-term outcomes of patients who underwent percutaneous sacroiliac joint stabilisation.

Methods

Between July 2004 and February 2011, 73 patients underwent percutaneous sacroiliac joint fusion in our unit. All patients completed a short form (SF)-36 questionnaire, visual analogue pain score and Majeed scoring questionnaire prior to treatment and at last follow-up.

Results

55 patients (9 male and 46 female) completed follow-up. The average follow-up period was for 36.18 months (range 12–84). The mean preoperative SF-36 scores were 26.59 for physical health and 40.38 for mental health. The mean postoperative SF-36 scores were 42.93 for physical health and 52.77 for mental health. The mean visual analogue pain scores were 8.1 preoperative and 4.5 postoperative. The mean pelvic specific scoring were 36.9 preoperative and 64.78 postoperative. We noted that patients who had previous instrumented spinal surgery did significantly worse than those who had not. We had two nerve root-related complications.

Conclusion

We conclude that in selected patient group who respond positively to CT-guided injection, a percutaneous SI joint stabilisation is beneficial in effecting pain relief and functional improvement.

Keywords

Sacroiliac joint stabilisation Percutaneous Sacroiliac joint pain Failed back syndrome Sacroiliac joint pain 

Notes

Conflict of interest

None.

References

  1. 1.
    Wise CL, Dall BE (2008) Minimally invasive sacroiliac arthrodesis: outcomes of a new technique. J Spinal Disord Tech 21(8):579–584. doi:10.1097/BSD.0b013e31815ecc4b PubMedCrossRefGoogle Scholar
  2. 2.
    Smith-Peterson MN (1921) Arthrodesis of the sacroiliac joint. A new method of approach. J Orthop Surg 3:400–405Google Scholar
  3. 3.
    Shuler TE, Boone DC, Gruen GS, Peitzman AB (1995) Percutaneous iliosacral screw fixation: early treatment for unstable posterior pelvic ring disruptions. J Trauma 38(3):453–458PubMedCrossRefGoogle Scholar
  4. 4.
    Khurana A, Guha AR, Mohanty K, Ahuja S (2009) Percutaneous fusion of the sacroiliac joint with hollow modular anchorage screws: clinical and radiological outcome. J Bone Joint Surg Br 91(5):627–631. doi:10.1302/0301-620X.91B5.21519 PubMedGoogle Scholar
  5. 5.
    Al-Khayer A, Hegarty J, Hahn D, Grevitt MP (2008) Percutaneous sacroiliac joint arthrodesis: a novel technique. J Spinal Disord Tech 21(5):359–363. doi:10.1097/BSD.0b013e318145ab96 PubMedCrossRefGoogle Scholar
  6. 6.
    Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483PubMedCrossRefGoogle Scholar
  7. 7.
    Majeed SA (1989) Grading the outcome of pelvic fractures. J Bone Joint Surg Br 71(2):304–306PubMedGoogle Scholar
  8. 8.
    Hansen HC, McKenzie-Brown AM, Cohen SP, Swicegood JR, Colson JD, Manchikanti L (2007) Sacroiliac joint interventions: a systematic review. Pain Physician 10(1):165–184PubMedGoogle Scholar
  9. 9.
    Albert H, Godskesen M, Westergaard J (2000) Evaluation of clinical tests used in classification procedures in pregnancy-related pelvic joint pain. Eur Spine J 9(2):161–166PubMedCrossRefGoogle Scholar
  10. 10.
    Gaenslen FJ (1927) Sacroiliac arthrodesis: indications, author’s technique and end-results. J Am Med Assoc 89:2031–2035CrossRefGoogle Scholar
  11. 11.
    Robinson HS, Brox JI, Robinson R, Bjelland E, Solem S, Telje T (2007) The reliability of selected motion- and pain provocation tests for the sacroiliac joint. Man Ther 12(1):72–79. doi:10.1016/j.math.2005.09.004 PubMedCrossRefGoogle Scholar
  12. 12.
    Simopoulos TT, Manchikanti L, Singh V, Gupta S, Hameed H, Diwan S, Cohen SP (2012) A systematic evaluation of prevalence and diagnostic accuracy of sacroiliac joint interventions. Pain Physician 15(3):E305–E344PubMedGoogle Scholar
  13. 13.
    Johansson HR, Bergschmidt P, Skripitz R, Finze S, Bader R, Mittelmeier W (2010) Impact of preoperative function on early postoperative outcome after total hip arthroplasty. J Orthop Surg (Hong Kong) 18(1):6–10Google Scholar
  14. 14.
    Baumann C, Rat AC, Osnowycz G, Mainard D, Cuny C, Guillemin F (2009) Satisfaction with care after total hip or knee replacement predicts self-perceived health status after surgery. BMC Musculoskelet Disord 10:150. doi:10.1186/1471-2474-10-150 PubMedCrossRefGoogle Scholar
  15. 15.
    Brennan P, Silman A (1995) Why the gender difference in susceptibility to rheumatoid arthritis? Ann Rheum Dis 54(9):694–695PubMedCrossRefGoogle Scholar
  16. 16.
    DePalma MJ, Ketchum JM, Saullo TR (2012) Multivariable analyses of the relationships between age, gender, and body mass index and the source of chronic low back pain. Pain Med 13(4):498–506. doi:10.1111/j.1526-4637.2012.01339.x PubMedCrossRefGoogle Scholar
  17. 17.
    Weil YA, Nousiainen MT, Helfet DL (2007) Removal of an iliosacral screw entrapping the L5 nerve root after failed posterior pelvic ring fixation: a case report. J Orthop Trauma 21(6):414–417. doi:10.1097/BOT.0b013e3180cab6b5 PubMedCrossRefGoogle Scholar
  18. 18.
    Tonetti J, Cazal C, Eid A, Badulescu A, Martinez T, Vouaillat H, Merloz P (2004) Neurological damage in pelvic injuries: a continuous prospective series of 50 pelvic injuries treated with an iliosacral lag screw. Rev Chir Orthop Reparatrice Appar Mot 90(2):122–131PubMedCrossRefGoogle Scholar
  19. 19.
    Marmor M, Lynch T, Matityahu A (2010) Superior gluteal artery injury during iliosacral screw placement due to aberrant anatomy. Orthopedics 33(2):117–120. doi:10.3928/01477447-20100104-26 PubMedCrossRefGoogle Scholar
  20. 20.
    Buchowski JM, Kebaish KM, Sinkov V, Cohen DB, Sieber AN, Kostuik JP (2005) Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint. Spine J 5(5):520–528. doi:10.1016/j.spinee.2005.02.022 (discussion 529)PubMedCrossRefGoogle Scholar
  21. 21.
    Katz V, Schofferman J, Reynolds J (2003) The sacroiliac joint: a potential cause of pain after lumbar fusion to the sacrum. J Spinal Disord Tech 16(1):96–99PubMedCrossRefGoogle Scholar
  22. 22.
    Maigne JY, Planchon CA (2005) Sacroiliac joint pain after lumbar fusion. A study with anesthetic blocks. Eur Spine J 14(7):654–658. doi:10.1007/s00586-004-0692-6 PubMedCrossRefGoogle Scholar
  23. 23.
    Gates GF, McDonald RJ (1999) Bone SPECT of the back after lumbar surgery. Clin Nucl Med 24(6):395–403PubMedCrossRefGoogle Scholar
  24. 24.
    Ivanov AA, Kiapour A, Ebraheim NA, Goel V (2009) Lumbar fusion leads to increases in angular motion and stress across sacroiliac joint: a finite element study. Spine 34(5):E162–E169. doi:10.1097/BRS.0b013e3181978ea3 PubMedCrossRefGoogle Scholar
  25. 25.
    Cinotti G, Roysam GS, Eisenstein SM, Postacchini F (1998) Ipsilateral recurrent lumbar disc herniation. A prospective, controlled study. J Bone Joint Surg Br 80(5):825–832PubMedCrossRefGoogle Scholar
  26. 26.
    Teixeira MJ, Yeng LT, Garcia OG, Fonoff ET, Paiva WS, Araujo JO (2011) Failed back surgery pain syndrome: therapeutic approach descriptive study in 56 patients. Rev Assoc Med Bras 57(3):282–287PubMedCrossRefGoogle Scholar
  27. 27.
    Bokov A, Isrelov A, Skorodumov A, Aleynik A, Simonov A, Mlyavykh S (2011) An analysis of reasons for failed back surgery syndrome and partial results after different types of surgical lumbar nerve root decompression. Pain Physician 14(6):545–557PubMedGoogle Scholar
  28. 28.
    Saal JS (2002) General principles of diagnostic testing as related to painful lumbar spine disorders: a critical appraisal of current diagnostic techniques. Spine 27(22):2538–2545. doi:10.1097/01.BRS.0000032127.87893.17 (discussion 2546)PubMedCrossRefGoogle Scholar
  29. 29.
    Schutz U, Grob D (2006) Poor outcome following bilateral sacroiliac joint fusion for degenerative sacroiliac joint syndrome. Acta Orthop Belg 72(3):296–308PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Lyndon W. Mason
    • 1
  • Iqroop Chopra
    • 1
  • Khitish Mohanty
    • 1
  1. 1.Trauma and Orthopaedic DepartmentUniversity Hospital of WalesCardiffUK

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