Minimally Invasive Sacroiliac Joint Fusion: The Current Evidence.

BACKGROUND: Fusion of the sacroiliac (SI) joint as a treatment for low back pain remains controversial. The purpose of this manuscript is to review the current literature and clinical outcomes of SI joint fusion surgery.
METHODS: We conducted a literature review and included studies with the term "sacroiliac joint fusion" that had at least 12 months of clinical follow-up, reported on minimally invasive techniques, and included patient-reported outcome measures.
RESULTS: Two approach types (dorsal and lateral) and numerous different implant manufacturers were identified. Most studies included level 4 data, with a small number of level 2 prospective cohort studies and 2 prospective level 1 studies. Every reviewed study reported clinical benefit in terms of improved pain scores or improvement in validated disability measures. Complication rates were low.
CONCLUSIONS: Minimally invasive SI joint fusion provides clinically significant improvement in pain scores and disability in most patients, across multiple studies and implant manufacturers. LEVEL OF EVIDENCE: 5. CLINICAL RELEVANCE: Emerging evidence in support of SI joint fusion indicates that clinicians should examine the SI joint and include SI joint pain in their differential diagnosis for low back pain patients. ©International Society for the Advancement of Spine Surgery 2020.