Orthopaedic Surgery Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
Highmark Health Data Science R&D, Pittsburgh, Pennsylvania, USA.
Orthop Surg. 2021 Feb;13(1):71-76. doi: 10.1111/os.12832. Epub 2020 Dec 7.
To report patient-reported outcomes of minimally invasive sacroiliac (SI) joint fusion as a case series.
This study was a retrospective cohort study of patients 18 years of age and older who underwent a minimally invasive SI joint fusion by a single surgeon between 1 January 2013 and 31 December 2015. Routine demographic data, characteristics, and relevant surgical and clinical data were all collected for this group. In addition, patients completed preoperative and postoperative visual analog scale (VAS) and Short Form 36 (SF-36) questionnaires to assess outcomes. Patient selection for SI fusion was based on short-term resolution of symptoms (80% or greater relief) with an image-guided intra-articular injection of local anesthetic. Routine statistical analysis was performed using the Wilcoxon signed rank test, Fisher's exact test, or χ analysis as appropriate.
This study included 19 patients comprising 24 SI fusions, with a mean follow-up of 58 months. The average patient age was 50 years and the average surgical blood loss was 25 cc. Men comprised 79% of the cohort. The VAS score improved from 7 to 3 (P = 0.0001). SF-36 physical function, role limitations due to physical health, and role limitations due to emotional health improved to a statistically significant extent. General health was not significantly changed. Every patient showed improvement in their SF-36 physical function scores (mean 40 preoperatively to 55 at final follow up) and 18 of 19 showed improvement in the VAS score (mean 7 preoperatively to 3 at final follow-up).
In appropriately selected patients, minimally invasive SI joint fusion results in decreased pain and improved physical functioning of patients, which is sustained for more than 4 years post-procedure.
报告经皮微创骶髂（SI）关节融合术的患者报告结局，采用病例系列研究方法。
本研究为单外科医生于 2013 年 1 月 1 日至 2015 年 12 月 31 日期间对 18 岁及以上患者进行微创 SI 关节融合术的回顾性队列研究。收集了该组患者的常规人口统计学数据、特征以及相关的手术和临床数据。此外，患者在术前和术后均完成视觉模拟量表（VAS）和健康调查简表 36（SF-36）问卷，以评估结局。SI 融合患者的选择基于短期症状缓解（80%或更高缓解率），同时对关节内进行影像引导下局部麻醉注射。采用 Wilcoxon 符号秩检验、Fisher 确切检验或 χ 分析等适当的常规统计分析。
本研究纳入了 19 例患者（共 24 个 SI 融合），平均随访 58 个月。患者的平均年龄为 50 岁，平均手术失血量为 25cc。男性占队列的 79%。VAS 评分从 7 分降至 3 分（P=0.0001）。SF-36 躯体功能、因躯体健康问题所致的角色受限和因情绪健康问题所致的角色受限均有显著改善。一般健康状况无明显变化。所有患者的 SF-36 躯体功能评分均有改善（术前平均 40 分，末次随访时为 55 分），19 例中有 18 例患者的 VAS 评分有改善（术前平均 7 分，末次随访时为 3 分）。
在适当选择的患者中，经皮微创 SI 关节融合术可减轻疼痛，改善患者躯体功能，且术后 4 年以上仍可维持。
