Kim Jong T, Rudolf Leonard M, Glaser John A
Medical University of South Carolina, Department of Orthopaedic Surgery, Charleston, SC, USA.
Open Orthop J. 2013;7:51-6. doi: 10.2174/1874325001307010051. Epub 2013 Feb 22.
Independent retrospective review of a single surgeon's experience with a new technique of SI fixation.
Examine results of percutaneous fixation of the SI joint with porous coated triangular titanium implants.
Diagnosis and treatment of a dysfunctional sacroiliac joint is challenging as well as controversial. Recently, percutaneous stabilization techniques have been implemented for fixation. There is minimal literature published on this technique.
Charts, radiographs, and CT scans of 31 patients operated on by a single surgeon were de-identified and randomized and then reviewed by investigators not involved with the care of the patients. Reviewers had no relationship with the implant manufacturer at the time of the review.
intraoperative and postoperative complication, EBL, hospital stays, postoperative image location and number of lucent implants, ingrowth into implants, and bone across SI joint.
27 patients expressed satisfaction, 4 patients did not. Pain relief was noted to be Complete (16 patients), Excellent (5 patients), Good (9 patients), and Fair (1 patients). Four patients had postoperative complications. These were infected hematoma (2), L5 nerve root irritation (1), and L5-S1 discitis (1). One patient required revision. On 6 month postop CT scan, 18/19 patients had radiographic evidence of bone ingrowth and bone into or across the SI joint was evident in 8/19 patients. Lucency was noted around at least one implant in 5/19 patients.
Results are promising for the use of this novel implant for a carefully selected group of patients with disabling SI dysfunction.
对一位外科医生采用骶髂关节固定新技术的经验进行独立回顾性研究。
研究使用多孔涂层三角形钛植入物经皮固定骶髂关节的效果。
骶髂关节功能障碍的诊断和治疗具有挑战性且存在争议。近来，已采用经皮稳定技术进行固定。关于该技术的文献报道极少。
对一位外科医生为31例患者实施手术的病历、X线片和CT扫描进行去识别化处理并随机分组，然后由未参与患者治疗的研究人员进行回顾。回顾时，评审人员与植入物制造商无关联。
术中及术后并发症、估计失血量、住院时间、术后影像中植入物的位置和透亮植入物数量、植入物内的骨长入情况以及骶髂关节处的骨情况。
27例患者表示满意，4例不满意。疼痛缓解情况为完全缓解（16例）、优（5例）、良（9例）、尚可（1例）。4例患者出现术后并发症，分别为感染性血肿（2例）、L5神经根刺激（1例）和L5 - S1椎间盘炎（1例）。1例患者需要翻修。术后6个月的CT扫描显示，19例患者中有18例有骨长入的影像学证据，19例患者中有8例在骶髂关节内或穿过骶髂关节有明显的骨生长。19例患者中有5例至少在一个植入物周围观察到透亮区。
对于精心挑选的患有致残性骶髂关节功能障碍的患者群体，使用这种新型植入物的效果很有前景。
