부산대학교 도서관

Dawood Sayed,1 Nasir Khatri,1 Adam Rupp,1 Christopher Bovinet,2 Nomen Azeem,3 Sean Li,4 Youssef Josephson,5 Jason Pope6 1Department of Anesthesiology, University of Kansas, Kansas City, KS, USA; 2The Spine Center of Southeast Georgia, Brunswick, GA, USA; 3Florida Spine & Pain Specialists, Riverview, FL, USA; 4Premier Pain Centers, Shrewsbury, NJ, USA; 5National Spine & Pain Centers, Voorhees Township, NJ, USA; 6Evolve Restorative Center, Santa Rosa, CA, USACorrespondence: Dawood Sayed, Department of Anesthesiology, University of Kansas, Kansas City, KS, USA, Email dsayed1@yahoo.comBackground: Studies have found that up to one-third of patients with LBP have sacroiliac joint (SIJ) dysfunction as a contributing cause. Historically, the management of SIJ dysfunction has been plagued by ineffectiveness or significant morbidity. In 2008, minimally invasive lateral SIJ fusion was developed. While this procedure is a safe and effective treatment, there is still a significant proportion of patients who will not experience therapeutic success. There is a paucity of data in the literature regarding the management of these patients. Recently, a novel posterior sacroiliac joint fusion device has been developed which minimizes complications compared to lateral approaches and may serve to salvage therapeutic failures in this patient population.Objective: Determine the efficacy and feasibility of a posterior SIJ fusion device as a salvage technique in patients who have not experienced therapeutic success following lateral SIJ fusion.Design: Multi-center retrospective observational study.Methods: Patients who had previously undergone lateral SIJ fusion and had persistent LBP were evaluated and diagnosed to have persistent primary SIJ pathology. All patients underwent posterior SIJ fusion utilizing a machined allograft transfixing sacroiliac fusion device. Demographic data and patient reported pain scores were collected.Results: A total of 7 patients who had undergone lateral SIJ fusion were included in the study and underwent posterior SIJ fusion. The mean patient reported pain improvement following posterior fusion was 80% with an average follow-up time of 10 months. Median morphine milliequivalents were 20 pre-procedure and 0 post-procedure.Conclusion: We were able to show significant reductions in pain scores and opioid consumption, which suggests that minimally invasive posterior SIJ utilizing a novel implant and technique may be a viable treatment option to salvage pain relief in this patient population. Further, the favorable safety profile of this posterior technique uniquely positions it to be an appropriate first-line surgical therapy.Keywords: sacroiliac joint pain, posterior SIJ fusion, lateral SIJ fusion, salvage, low back pain