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The use of primary sacroiliac joint fusion for lower back pain due to sacroiliac joint pathology: a systematic review and meta-analysis

Canadian Journal of Surgery, 2022-12, Vol.65, p.S160-S160 [Peer Reviewed Journal]

Copyright CMA Impact, Inc. Dec 2022 ;ISSN: 0008-428X ;EISSN: 1488-2310

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  • Title:
    The use of primary sacroiliac joint fusion for lower back pain due to sacroiliac joint pathology: a systematic review and meta-analysis
  • Author: Du, Jin Tong ; Abbas, Aazad ; Toor, Jay ; Versteeg, Anne ; Finkelstein, Joel
  • Subjects: Back pain ; Clinical outcomes ; Cohort analysis ; Pathology
  • Is Part Of: Canadian Journal of Surgery, 2022-12, Vol.65, p.S160-S160
  • Description: Background: Sacroiliac joint (SIJ) pathologies are well known causes of chronic low back pain; however, conservative versus operative management (CM) has been a point of contention. As such, the aim of this study was to quantify the effect of sacroiliac joint fusion (SIJF) on patient-reported outcomes in patients with chronic low back pain caused by SIJ pathology. Methods: Databases were searched before Aug. 18, 2020, for the treatment of SIJ pathology. The primary outcome measure was the Visual Analogue Scale (VAS) for lower back pain. The secondary outcome measure was the Oswestry Disability Index (ODI). For single-cohort studies, treatment outcomes were analyzed using the pooled mean VAS and ODI scores. For studies comparing SIJF with CM, treatment outcomes were analyzed using the standardized mean difference (SMD) for VAS and ODI scores. Results: A total of 558 patients and 6 studies were included: 2 randomized controlled trials and 4 prospective cohort studies. Five out of the 6 studies were industry funded. Mean pooled VAS scores at baseline were 76.3 (95% confidence interval [CI] 68.4 to 84.1) and at 6-month follow-up 31.0 (95% CI 27.9 to 34.0). Mean pooled ODI score at baseline was 56.7 (95% CI 53.1 to 60.2) and at 6-month follow-up was 32.4 (95% CI 30.4 to 34.4). According to VAS scores, the SMD between SIJF and CM at 6 months follow-up was -1.5 (95% CI -1.8 to -1.1). The SMD between SIJF and CM ODI scores at 6 months was -1.1 (95% CI -1.6 to -0.5). Conclusion: SIJF showed potential as a surgical treatment option for SIJ pathology. However, owing to the paucity of independent trials with long-term follow-up, definitive conclusions about SIJF efficacy are limited. This work supports further exploration of SIJF to controls through multicentre comparative studies with long-term follow-up.
  • Publisher: Ottawa: CMA Impact, Inc
  • Language: English
  • Identifier: ISSN: 0008-428X
    EISSN: 1488-2310
  • Source: GFMER Free Medical Journals
    PubMed Central
    Alma/SFX Local Collection
    ProQuest Central
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