Skip to main content
Erschienen in: European Spine Journal 6/2016

08.03.2016 | Review Article

Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis

verfasst von: Kiran Kumar Lingutla, Raymond Pollock, Sashin Ahuja

Erschienen in: European Spine Journal | Ausgabe 6/2016

Einloggen, um Zugang zu erhalten

Abstract

Background context

Although pain is generally regarded as originating in the lumbar spine, it has been estimated that in 15–30 % of patients, LBP originates from the sacroiliac joint (SIJ).

Purpose

To determine whether sacroiliac joint fusion (SIJF) for LBP is effective in reducing pain when the SIJ is known to be the pain generator.

Study design/setting

Systematic review and meta-analysis.

Methods

A systematic literature review and meta-analysis was performed of observational studies describing outcome of SIJF in patients with LBP. Outcome measures were VAS pain, ODI, SF-36 PCS/MCS and Majeed score. The following databases were searched: PubMed, Web of Science, Embase, Medline and Google scholar. The methodological quality of selected studies was assessed using the National Heart Lung and Blood Institute case series quality assessment tool. Meta-analysis was used to combine the studies for each outcome and forest plots were prepared. Outcomes were expressed as mean difference (MD).

Results

Six studies were included in the meta-analysis with a mean follow-up of 17.6 months. All outcomes showed statistical and clinical improvement (VAS pain MD: 54.8; 95 % CI 48.6, 61.0; n = 380; p < 0.001, ODI MD: 14.5; 95 % CI 8.4, 20.6; n = 102; p < 0.001, SF-36 PCS MD: -19.5; 95 % CI -24.7, -14.2; n = 140; p < 0.001, SF-36 MCS MD: −8.5; 95 % CI −12.9, −4.1; n = 198; p < 0.001 and Majeed score MD: −35.4; 95 % CI −48.5, −22.2; n = 140; p < 0.001).

Conclusions

SIJF appears to be a satisfactory procedure for alleviating pelvic girdle pain.
Literatur
1.
Zurück zum Zitat Schwarzer AC, Aprill CN, Bogduck M (1995) The sacroiliac joint in chronic low back pain. Spine 20:31–37CrossRefPubMed Schwarzer AC, Aprill CN, Bogduck M (1995) The sacroiliac joint in chronic low back pain. Spine 20:31–37CrossRefPubMed
2.
Zurück zum Zitat Vleeming A, Albert HB, Ostgaard HC et al (2008) European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 17(6):794–819CrossRefPubMedPubMedCentral Vleeming A, Albert HB, Ostgaard HC et al (2008) European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 17(6):794–819CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Schutz A, Grob D (2006) Poor outcome following bilateral sacroiliac joint fusion for degenerative sacroiliac joint syndrome. Acta Orthop Belg 72:296–308PubMed Schutz A, Grob D (2006) Poor outcome following bilateral sacroiliac joint fusion for degenerative sacroiliac joint syndrome. Acta Orthop Belg 72:296–308PubMed
4.
Zurück zum Zitat Kibsgard TJ, Roise O, Stug B (2014) Pelvic joint fusions in patients with severe pelvic girdle pain—a prospective single-subject research design study. BMC Musculoskelet Disord 15:85CrossRefPubMedPubMedCentral Kibsgard TJ, Roise O, Stug B (2014) Pelvic joint fusions in patients with severe pelvic girdle pain—a prospective single-subject research design study. BMC Musculoskelet Disord 15:85CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Zaidi HA, Montoure AJ, Dickman CA (2015) Surgical and clinical efficacy of sacroiliac joint fusion: a systematic review of the literature. J Neurosurg Spine 23:59–66CrossRefPubMed Zaidi HA, Montoure AJ, Dickman CA (2015) Surgical and clinical efficacy of sacroiliac joint fusion: a systematic review of the literature. J Neurosurg Spine 23:59–66CrossRefPubMed
7.
Zurück zum Zitat Higgins JPT, Green S (eds) (2009) Cochrane handbook for systematic reviews of interventions. Wiley-Blackwell, Chichester Higgins JPT, Green S (eds) (2009) Cochrane handbook for systematic reviews of interventions. Wiley-Blackwell, Chichester
8.
Zurück zum Zitat Majeed SA (1989) Grading the outcome of pelvic fractures. J Bone Joint Surg [Br] 71:304–306 Majeed SA (1989) Grading the outcome of pelvic fractures. J Bone Joint Surg [Br] 71:304–306
11.
Zurück zum Zitat RevMan [computer program]. Version 5.2.11, Nordic Cochrane Center, Copenhagen, 2013 RevMan [computer program]. Version 5.2.11, Nordic Cochrane Center, Copenhagen, 2013
12.
Zurück zum Zitat Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range and the size of the sample. BMC Med Res Methodol 5(1):13–20CrossRefPubMedPubMedCentral Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range and the size of the sample. BMC Med Res Methodol 5(1):13–20CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Headrick TC (2010) Statistical simulation: power method polynomials and other transformations. Chapman & Hall/CRC, Boca Raton, p 137 Headrick TC (2010) Statistical simulation: power method polynomials and other transformations. Chapman & Hall/CRC, Boca Raton, p 137
14.
Zurück zum Zitat Duhon BS, Cher DJ, Wine KD et al (2013) Safety and 6-month effectiveness of minimally invasive sacroiliac joint fusion: a prospective study. Med Dev Evid Res 6:219–229 Duhon BS, Cher DJ, Wine KD et al (2013) Safety and 6-month effectiveness of minimally invasive sacroiliac joint fusion: a prospective study. Med Dev Evid Res 6:219–229
15.
Zurück zum Zitat Mason LW, Chopra I (2013) The percutaneous stabilisation of the sacroiliac joint with hollow modular anchorage screws: a prospective outcome study. Euro Spine J 22:2325–2331CrossRef Mason LW, Chopra I (2013) The percutaneous stabilisation of the sacroiliac joint with hollow modular anchorage screws: a prospective outcome study. Euro Spine J 22:2325–2331CrossRef
16.
Zurück zum Zitat Rudolf L, Capobianco R (2014) Five year clinical and radiographic outcomes after minimally invasive sacroiliac joint fusion using triangular implants. Open Orthop J 8:375–383CrossRefPubMedPubMedCentral Rudolf L, Capobianco R (2014) Five year clinical and radiographic outcomes after minimally invasive sacroiliac joint fusion using triangular implants. Open Orthop J 8:375–383CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Sachs D, Capobianco R, Cher D et al (2014) One year outcomes after minimally invasive sacroiliac joint fusion with a series of triangular implants: a multicenter patient level analysis. Med Dev Evid Res 7:299–304 Sachs D, Capobianco R, Cher D et al (2014) One year outcomes after minimally invasive sacroiliac joint fusion with a series of triangular implants: a multicenter patient level analysis. Med Dev Evid Res 7:299–304
18.
Zurück zum Zitat Khurana A, Guha AR, Mohanty K et al (2009) Percutaneous fusion of the sacroiliac joint with hollow modular anchorage screws. J Bone Joint Surg 91:627–631CrossRef Khurana A, Guha AR, Mohanty K et al (2009) Percutaneous fusion of the sacroiliac joint with hollow modular anchorage screws. J Bone Joint Surg 91:627–631CrossRef
19.
20.
Zurück zum Zitat Stuber KJ (2007) Specificity, sensitivity and predictive values of clinical tests of the sacroiliac joint; a systematic review of the literature. J Can Chiropr Assoc 51(1):30–41PubMedPubMedCentral Stuber KJ (2007) Specificity, sensitivity and predictive values of clinical tests of the sacroiliac joint; a systematic review of the literature. J Can Chiropr Assoc 51(1):30–41PubMedPubMedCentral
21.
Zurück zum Zitat Berthelot JM, Labat JJ, Le Goff B et al (2006) Provocative sacroiliac joint maneuvers and sacroiliac joint block are unreliable for diagnosing sacroiliac joint pain. Joint Bone Spine 73(1):7–23CrossRef Berthelot JM, Labat JJ, Le Goff B et al (2006) Provocative sacroiliac joint maneuvers and sacroiliac joint block are unreliable for diagnosing sacroiliac joint pain. Joint Bone Spine 73(1):7–23CrossRef
22.
Zurück zum Zitat Tofuku K, Koga H, Komiya S (2015) The diagnostic value of single-photon emission computed tomography/computed tomography for severe joint dysfunction. Euro Spine J 24:859–863 Tofuku K, Koga H, Komiya S (2015) The diagnostic value of single-photon emission computed tomography/computed tomography for severe joint dysfunction. Euro Spine J 24:859–863
23.
Zurück zum Zitat Sembrano JN, Polly DW Jr (2009) How often is low back pain not coming form the back? Spine 34:E27–E32CrossRefPubMed Sembrano JN, Polly DW Jr (2009) How often is low back pain not coming form the back? Spine 34:E27–E32CrossRefPubMed
25.
Zurück zum Zitat Wise CL, Dall BE (2008) Minimally invasive sacroiliac arthrodesis: outcomes of a new technique. J Spinal Disord Tech 21:579–584CrossRefPubMed Wise CL, Dall BE (2008) Minimally invasive sacroiliac arthrodesis: outcomes of a new technique. J Spinal Disord Tech 21:579–584CrossRefPubMed
26.
Zurück zum Zitat Slinkard N, Agel J, Swiontkowski MF (2013) Documenation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence outcome? Eur Spine J 22:2318–2324CrossRefPubMedPubMedCentral Slinkard N, Agel J, Swiontkowski MF (2013) Documenation of outcomes for sacroiliac joint fusion: does prior spinal fusion influence outcome? Eur Spine J 22:2318–2324CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Kibsgard TJ, Roise O, Sudmann E (2013) Pelvic joint fusions in patients with chronic pelvic girdle pain: a 23-year follow-up. Eur Spine J 22:871–877CrossRefPubMedPubMedCentral Kibsgard TJ, Roise O, Sudmann E (2013) Pelvic joint fusions in patients with chronic pelvic girdle pain: a 23-year follow-up. Eur Spine J 22:871–877CrossRefPubMedPubMedCentral
28.
29.
Zurück zum Zitat Hägg O, Fritzell P, Nordwall A (2003) The clinical importance of changes in outcome scores after treatment for chronic low back pain. Eur Spine J 12:12–20PubMed Hägg O, Fritzell P, Nordwall A (2003) The clinical importance of changes in outcome scores after treatment for chronic low back pain. Eur Spine J 12:12–20PubMed
30.
Zurück zum Zitat Ostelo RW, de Vet HC (2005) Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol 19:593–607CrossRefPubMed Ostelo RW, de Vet HC (2005) Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol 19:593–607CrossRefPubMed
32.
Zurück zum Zitat Copay AG, Glassman SD, Subach BR (2008) Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J 8:968–974CrossRefPubMed Copay AG, Glassman SD, Subach BR (2008) Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J 8:968–974CrossRefPubMed
Metadaten
Titel
Sacroiliac joint fusion for low back pain: a systematic review and meta-analysis
verfasst von
Kiran Kumar Lingutla
Raymond Pollock
Sashin Ahuja
Publikationsdatum
08.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 6/2016
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4490-8

Weitere Artikel der Ausgabe 6/2016

European Spine Journal 6/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.