PMID- 38193936
OWN - NLM
STAT- MEDLINE
DCOM- 20240304
LR  - 20240410
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
VI  - 33
IP  - 2
DP  - 2024 Feb
TI  - Effect of revision sacroiliac joint fusion on unresolved pain and disability: a 
      retrospective cohort study.
PG  - 533-542
LID - 10.1007/s00586-023-08104-6 [doi]
AB  - PURPOSE: The sacroiliac (SI) joint is recognized as a source of low back pain in 
      15-30% of patients. Though randomized controlled trials have shown clinical 
      improvement following SI joint fusion in 83.1% of patients, revision rates of 
      2.9% within 2 years have been reported. There is a paucity of literature 
      reviewing this small yet significant population of patients requiring revision 
      surgery. METHODS: Following IRB approval, retrospective review of patients, who 
      underwent a revision SI joint fusion from 2009 to 2021 was completed. 
      Patient-reported outcomes were measured before and at each clinic visit after 
      surgery with visual analoge scale (VAS) for back pain and Oswestry Disability 
      Index (ODI). Patient characteristics (chronic opiate use and prior lumbar fusion) 
      and surgical factors (operative approach, type/number of implants and use of bone 
      graft) were recorded. Patient-reported outcomes were evaluated with Paired t and 
      Wilcoxon signed rank tests. Univariate and multivariate logistic regression 
      determined if patients met the minimally clinical important differences (MCID) 
      for VAS-back pain and ODI scores at 1 year. RESULTS: Fifty-two patients (77% 
      female) with an average age of 49.1 (SD +/- 11.1) years met inclusion criteria. 
      Forty-four had single sided revisions and eight bilateral revisions. At 1 year 
      follow-up there was no significant improvement in VAS-Back (p = 0.06) or ODI 
      (p = 0.06). Patients with chronic opioid use were 8.5 times less likely to 
      achieve the MDC for ODI scores (OR 0.118, p = 0.029). There was no difference in 
      outcomes when comparing the different surgical approaches (p = 0.41). CONCLUSION: 
      Our study demonstrates patients undergoing revision surgery have moderate 
      improvement in low back pain, however, few have complete resolution of their 
      symptoms. Specific patient factors, such as chronic opiate use and female sex may 
      decrease the expected improvement in patient-reported outcomes following surgery. 
      Failure to obtain relief may be due to incorrect indications, lack of biologic 
      fusion and/or presence of co-pathologies. Further clinical examination and 
      consistent long-term follow-up, clarify the role revision surgery plays in 
      long-term patient outcomes.
CI  - (c) 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Brown, Levi
AU  - Brown L
AUID- ORCID: 0000-0003-2200-0231
AD  - The Department of Orthopedic Surgery, University of Minnesota, 2512 Riverside 
      Avenue South, Suite R200, Minneapolis, MN, 55454, USA.
FAU - Swiontkowski, Marc
AU  - Swiontkowski M
AUID- ORCID: 0000-0001-7036-1782
AD  - The Department of Orthopedic Surgery, University of Minnesota, 2512 Riverside 
      Avenue South, Suite R200, Minneapolis, MN, 55454, USA.
FAU - Odland, Kari
AU  - Odland K
AUID- ORCID: 0000-0003-1244-2685
AD  - The Department of Orthopedic Surgery, University of Minnesota, 2512 Riverside 
      Avenue South, Suite R200, Minneapolis, MN, 55454, USA. kodland@umn.edu.
FAU - Polly, David W Jr
AU  - Polly DW Jr
AUID- ORCID: 0000-0001-7572-6584
AD  - The Department of Orthopedic Surgery, University of Minnesota, 2512 Riverside 
      Avenue South, Suite R200, Minneapolis, MN, 55454, USA.
FAU - Haselhuhn, Jason
AU  - Haselhuhn J
AUID- ORCID: 0000-0002-8658-8137
AD  - The Department of Orthopedic Surgery, University of Minnesota, 2512 Riverside 
      Avenue South, Suite R200, Minneapolis, MN, 55454, USA.
LA  - eng
PT  - Journal Article
DEP - 20240109
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
RN  - 0 (Opiate Alkaloids)
SB  - IM
MH  - Humans
MH  - Female
MH  - Middle Aged
MH  - Male
MH  - *Low Back Pain/surgery
MH  - Retrospective Studies
MH  - Sacroiliac Joint/surgery
MH  - Arthrodesis
MH  - *Spinal Diseases
MH  - *Opiate Alkaloids
OTO - NOTNLM
OT  - Disability
OT  - Pain
OT  - Revision surgery
OT  - SI fusion
OT  - SI joint
EDAT- 2024/01/09 13:44
MHDA- 2024/03/04 06:47
CRDT- 2024/01/09 11:04
PHST- 2023/06/05 00:00 [received]
PHST- 2023/12/11 00:00 [accepted]
PHST- 2023/06/05 00:00 [revised]
PHST- 2024/03/04 06:47 [medline]
PHST- 2024/01/09 13:44 [pubmed]
PHST- 2024/01/09 11:04 [entrez]
AID - 10.1007/s00586-023-08104-6 [pii]
AID - 10.1007/s00586-023-08104-6 [doi]
PST - ppublish
SO  - Eur Spine J. 2024 Feb;33(2):533-542. doi: 10.1007/s00586-023-08104-6. Epub 2024 
      Jan 9.