PMID- 35772982
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221122
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 16
IP  - 3
DP  - 2022 Jun
TI  - Minimally Invasive Sacroiliac Joint Fusion vs Conservative Management in Patients 
      With Sacroiliac Joint Dysfunction: A Systematic Review and Meta-Analysis.
PG  - 472-480
LID - 10.14444/8241 [doi]
AB  - BACKGROUND: The sacroiliac joint (SIJ) is affected in 14% to 22% in individuals 
      presenting with chronic low back or buttock pain. This percentage is even higher 
      in patients who underwent lumbar fusion surgery: 32% to 42%. Currently, there is 
      no standard treatment or surgical indication for SIJ dysfunction. When patients 
      do not respond well to nonsurgical treatment, minimally invasive sacroiliac joint 
      fusion (MISJF) seems to be a reasonable option. This systematic review and 
      meta-analysis evaluates the current literature on the effectiveness of MISJF 
      compared to conservative management in patients with SIJ dysfunction. METHODS: A 
      systematic search of health-care databases was conducted according to the 
      Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 
      guidelines. Inclusion criteria were randomized controlled trials (RCTs) or 
      prospective and retrospective comparative cohort studies that compared MISJF with 
      conservative management. Primary outcome measures were pain, disability, and 
      patient satisfaction measured by patient-reported outcome measures. Secondary 
      outcomes were adverse events (AEs), serious AEs, financial benefits, and costs. 
      RESULTS: Two RCTs and one retrospective cohort study were included comparing 
      MISJF and conservative management with regard to pain and disability outcome, 
      encompassing 388 patients (207 conservative and 181 surgical). In a pooled mean 
      difference analysis, MISJF demonstrated greater reduction in visual analog 
      scale-pain score compared to conservative management: -37.03 points (95%CI 
      [-43.91, -30.15], P < 0.001). Moreover, MISJF was associated with a greater 
      reduction in Oswestry Disability Index outcome: -21.14 points (95% CI [-24.93, 
      -17.35], P < 0.001). AEs were low among the study groups and comparable across 
      the included studies. One cost-effectiveness analysis was also included and 
      reported that MISJF is more cost-effective than conservative management.001). AEs 
      were low among the study groups and comparable across the included studies. One 
      cost-effectiveness analysis was also included and reported that MISJF is more 
      cost-effective than conservative management. CONCLUSIONS: This systematic review 
      and meta-analysis suggest that MISJF, using cannulated triangular, titanium 
      implants, is more effective and cost-effective than conservative management in 
      reducing pain and disability in patients with SIJ dysfunction. Further 
      well-powered, independent research is needed to improve the overall evidence.
CI  - This manuscript is generously published free of charge by ISASS, the 
      International Society for the Advancement of Spine Surgery. Copyright (c) 2022 
      ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.
FAU - Hermans, Sem M M
AU  - Hermans SMM
AD  - Department of Orthopaedic Surgery, Zuyderland Medical Center, Heerlen, the 
      Netherlands semhermans@hotmail.com.
AD  - Care and Public Health Research Institute (CAPHRI) Maastricht University, 
      Maastricht, the Netherlands.
FAU - Droeghaag, Ruud
AU  - Droeghaag R
AD  - Department of Orthopaedic Surgery, Zuyderland Medical Center, Heerlen, the 
      Netherlands.
AD  - Care and Public Health Research Institute (CAPHRI) Maastricht University, 
      Maastricht, the Netherlands.
AD  - Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the 
      Netherlands.
FAU - Schotanus, Martijn G M
AU  - Schotanus MGM
AD  - Department of Orthopaedic Surgery, Zuyderland Medical Center, Heerlen, the 
      Netherlands.
AD  - Care and Public Health Research Institute (CAPHRI) Maastricht University, 
      Maastricht, the Netherlands.
FAU - Santbrink, Henk van
AU  - Santbrink HV
AD  - Care and Public Health Research Institute (CAPHRI) Maastricht University, 
      Maastricht, the Netherlands.
AD  - Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the 
      Netherlands.
AD  - Department of Neurosurgery, Zuyderland Medical Center, Heerlen, the Netherlands.
FAU - van Hemert, Wouter L W
AU  - van Hemert WLW
AD  - Department of Orthopaedic Surgery, Zuyderland Medical Center, Heerlen, the 
      Netherlands.
FAU - Curfs, Inez
AU  - Curfs I
AD  - Department of Orthopaedic Surgery, Zuyderland Medical Center, Heerlen, the 
      Netherlands.
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC9650193
OTO - NOTNLM
OT  - conservative management
OT  - minimally invasive sacroiliac joint fusion
OT  - sacroiliac joint
OT  - sacroiliac joint dysfunction
OT  - systematic review and meta-analysis
COIS- Declaration of Conflicting Interests: The authors report no conflicts of interest 
      in this work.
EDAT- 2022/07/01 06:00
MHDA- 2022/07/01 06:01
PMCR- 2022/03/28
CRDT- 2022/06/30 21:41
PHST- 2022/06/30 21:41 [entrez]
PHST- 2022/07/01 06:00 [pubmed]
PHST- 2022/07/01 06:01 [medline]
PHST- 2022/03/28 00:00 [pmc-release]
AID - 16/3/472 [pii]
AID - IJSSURGERY-D-21-00117 [pii]
AID - 10.14444/8241 [doi]
PST - ppublish
SO  - Int J Spine Surg. 2022 Jun;16(3):472-480. doi: 10.14444/8241.