使用术中立体定向导航的圆柱形螺纹植入物进行微创骶髂关节融合术

Minimally Invasive Sacroiliac Joint Fusion with Cylindrical Threaded Implants Using Intraoperative Stereotactic Navigation.

作者信息

Rajpal Sharad, Burneikiene Sigita

机构信息

Boulder Neurosurgical Associates; and Justin Parker Neurological Institute, Boulder, Colorado, USA.

Boulder Neurosurgical Associates; and Justin Parker Neurological Institute, Boulder, Colorado, USA.

出版信息

World Neurosurg. 2019 Feb;122:e1588-e1591. doi: 10.1016/j.wneu.2018.11.116. Epub 2018 Nov 23.

Abstract

BACKGROUND

Significant progress in hardware and surgical techniques for sacroiliac joint (SIJ) fusion surgeries has facilitated safer and more efficacious procedures for patients. Triangular-shaped implants for SIJ fusions are the most-studied devices and have demonstrated good short-term and long-term clinical outcomes. Reports on cylindrical threaded implants are very limited. Owing to biomechanical differences in the implants and the surgical techniques required for their placement, previously reported results may not be applicable to cylindrical threaded implants. The aim of this study was to report preliminary clinical experience with minimally invasive SIJ fusion using intraoperative stereotactic navigation and the Rialto SI Fusion System.

METHODS

We retrospectively reviewed 24 patients who underwent SIJ fusions between May 2015 and October 2017 performed by a single surgeon.

RESULTS

Mean total satisfaction score was 89.0% ± 27.6%. A statistically significant reduction (P = 0.0028) in low back pain scores was noted from an average baseline score of 6.6 ± 2.4 to 3.7 ± 3.3 postoperatively. Leg pain scores decreased from 4.8 ± 3.8 to 1.5 ± 2.9 (P = 0.0034). Mean surgical time was 53.0 ± 13.9 minutes. It took significantly longer (P = 0.0089) to perform the initial 13 cases (59.9 ± 15.2 minutes) compared with subsequent cases (45.4 ± 7.3 minutes). Estimated blood loss was minimal (10.4 ± 5.2 mL).

CONCLUSIONS

Minimally invasive SI joint fusion using cylindrical threaded implants can be safely performed with minimal morbidity and good clinical outcomes.

摘要

背景

骶髂关节(SIJ)融合手术的硬件和手术技术取得了重大进展,为患者带来了更安全、更有效的手术。用于SIJ融合的三角形植入物是研究最多的器械,并已显示出良好的短期和长期临床效果。关于圆柱形螺纹植入物的报道非常有限。由于植入物的生物力学差异以及放置所需的手术技术不同,先前报道的结果可能不适用于圆柱形螺纹植入物。本研究的目的是报告使用术中立体定向导航和Rialto SI融合系统进行微创SIJ融合的初步临床经验。

方法

我们回顾性分析了2015年5月至2017年10月间由单一外科医生进行SIJ融合手术的24例患者。

结果

总体满意度平均得分为89.0%±27.6%。下腰痛评分从平均基线评分6.6±2.4显著降低(P = 0.0028)至术后的3.7±3.3。腿痛评分从4.8±3.8降至1.5±2.9(P = 0.0034)。平均手术时间为53.0±13.9分钟。与后续病例(45.4±7.3分钟)相比,最初13例病例的手术时间明显更长(P = 0.0089)(59.9±15.2分钟)。估计失血量极少(10.4±5.2 mL)。

结论

使用圆柱形螺纹植入物进行微创骶髂关节融合术可以安全地进行,发病率极低,临床效果良好。

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