College of Medicine, University of Florida, Gainesville, Florida, USA.
College of Medicine, University of Florida, Gainesville, Florida, USA.
World Neurosurg. 2022 Dec;168:120-132. doi: 10.1016/j.wneu.2022.09.094. Epub 2022 Sep 26.
Sacroiliac joint (SIJ) dysfunction is a significant contributor to lower back pain. Although open surgical treatment for persistent pain has long been the standard, it is associated with significant surgical morbidity, high complication rates, and variable patient satisfaction. Minimally invasive SIJ fusion (MISJF) is a promising and effective approach. This scoping review was carried out to map the available evidence on outcomes after MISJF.
This review was conducted in accordance with the PRISMA guidelines. Inclusion criteria were all full-text articles reporting on functional, clinical, and quality-of-life outcomes after MISJF. Exclusion criteria consisted of studies including patients with traumatic sacroiliac injuries or congenital spinal abnormalities, and procedures involving multiple spinal fusions or an open approach to SIJ fusion.
A total of 1305 studies were identified across 6 databases. After duplicate removal and further screening, 33 independent studies were included in our review. Regarding pain management, 21 studies reported visual analog scale scores, and all showed significant (>50%) reductions in pain at multiple time points postoperatively. Six studies reported on quality-of-life outcomes and showed significant increases, especially compared with nonsurgical treatment.
This study highlights the existing literature regarding outcomes after MISJF. MISJF provides favorable responses in quality-of-life metrics, pain scores, and overall postoperative outcomes in select patients. Although outcomes have been widely studied, more studies, especially prospectively designed and those without industry influence, should be performed to elucidate the optimal management of patients with intractable SIJ pain.
骶髂关节（SIJ）功能障碍是导致下腰痛的重要原因。虽然开放性手术治疗持续性疼痛一直是标准治疗方法，但它与显著的手术发病率、高并发症发生率和患者满意度变化有关。微创 SIJ 融合术（MISJF）是一种有前途且有效的方法。本范围综述旨在绘制关于 MISJF 后结果的现有证据图谱。
本综述按照 PRISMA 指南进行。纳入标准为所有报告 MISJF 后功能、临床和生活质量结果的全文文章。排除标准包括包括创伤性骶髂损伤或先天性脊柱异常的患者以及涉及多个脊柱融合或 SIJ 融合开放方法的研究。
共在 6 个数据库中确定了 1305 项研究。去除重复项并进一步筛选后，有 33 项独立研究纳入本综述。关于疼痛管理，21 项研究报告了视觉模拟评分，所有研究均显示术后多个时间点疼痛显著（>50%）减轻。6 项研究报告了生活质量结果，显示显著增加，尤其是与非手术治疗相比。
本研究强调了关于 MISJF 后结果的现有文献。MISJF 在选择患者的生活质量指标、疼痛评分和整体术后结果方面提供了良好的反应。尽管已经广泛研究了结果，但应该进行更多的研究，特别是前瞻性设计的和不受行业影响的研究，以阐明对难治性 SIJ 疼痛患者的最佳管理。
