Sacroiliac arthrodesis using a posterior midline fascial splitting approach and pedicle screw instrumentation: a new technique.

Many techniques for sacroiliac arthrodesis have been described. No single technique is universally accepted as the standard. The current report describes a new technique using a midline fascial-splitting approach and pedicle screw instrumentation. Four consecutive patients with nontraumatic disorders of the sacroiliac joint who have undergone successful arthrodesis by the described technique are presented. One patient had a spontaneous sacroiliac disruption secondary to rheumatoid arthritis, and was returned to her previous ambulatory status after fusion of the disrupted joint. Her fusion remained stable for 9 years postoperatively. The others had degeneration of the sacroiliac joint that was symptomatically improved by arthrodesis. The described method of sacroiliac arthrodesis may be an attractive option for surgeons who are familiar with pedicle screw instrumentation techniques.