Mini-open sacroiliac joint fusion with direct bone grafting and minimally invasive fixation using intraoperative navigation

Andrew W. Cleveland III, Derek T. Nhan, Michelle Akiyama, Christopher J. Kleck, Andriy Noshchenko, Vikas V. Patel


Background: Describe a novel technique for sacroiliac arthrodesis using intraoperative navigation, direct bone grafting, and minimally invasive implants. Report on the outcomes of the first cohort of these patients.
Methods: Institutional review board (IRB) approved, single center, two surgeon, retrospective study.
Results: All patients were 18 years or older, primary sacroiliac fusions, and underwent novel technique described. Fifty patients underwent 57 surgeries. Twelve male/38 female patients. All received three sacroiliac implants. Average blood loss 42.8 mL. Average length of stay 1.9 nights. Average follow-up 13.96±13 months. Statistically significant improvements in Visual Analogue Scale (VAS) scores (<0.001) for all time periods 6 weeks, 3 months, 6 months, 12 months compared to preop. Other outcomes scores [Oswestry Disability Index (ODI), and Denver Sacroiliac Joint Questionnaire (DSIJQ)] also showed a general trend for clinical improvement at all postoperative time periods. Of 2/57 (3.5%) complications were identified. No patients required surgical revision within the study window.
Conclusions: Limited open sacroiliac arthrodesis using minimally invasive implants, intraoperative navigation, and direct open bone grafting is safe and demonstrates clinical benefit, similar to other techniques for minimally invasive sacroiliac arthrodesis. There is potential for improved long-term outcomes from increased union rates.