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.