Ton Andy, Mertz Kevin, Abdou Marc, Hang Nicole, Mills Emily S, Hah Raymond J, Alluri Ram K, Wang Jeffrey C
Department of Orthopaedic Surgery, Keck School of Medicine at The University of Southern California, Los Angeles, CA, USA.
Global Spine J. 2025 Mar;15(2):518-525. doi: 10.1177/21925682231196448. Epub 2023 Aug 17.
STUDY DESIGN/SETTING: Retrospective cohort analysis.
This study evaluates utilization and demographic trends for sacroiliac joint (SIJ) fusions across the United States (US).
Patients who underwent SIJ fusion from 2010-2021 were identified within the PearlDiver national database using International Classification of Disease (ICD-9, ICD-10) and Current Procedural Terminology (CPT) codes. Indications for trauma, malignancy, or infection were excluded. Demographic, clinical, and procedure characteristics were recorded along with annual utilization rates. Annual percent change (APC) was calculated to identify increasing or decreasing utilization from prior years. Negative binomial regression was performed to project subsequent utilization for 2022-2028. Chi-squared analysis followed by post-hoc comparisons were used to compare differences in diagnostic indications and clinical features associated with SIJ fusion across regions. Bonferroni adjustments were applied to -values for pairwise analyses.
Overall, 18 032 patients (69.8% female, mean age = 51.0 13.4 years) underwent SIJ fusion between 2010 and 2021. Annual utilization increased by 33.5% on average. The South comprised the largest proportion of cases (48.9%). Projections for 2022-2028 predict continued growth in procedures, with an overall increase of 1100% from 1350 cases in 2021 to 16 195 by end of 2028. Spondyloarthropathy-induced sacroilitis was the most prevalent diagnostic indication nationwide (51%). Of patients undergoing SIJ fusion, 18% had a prior lumbar fusion, and only 45% received a preoperative diagnostic SIJ injection.
As SIJ fusion is increasingly utilized to treat refractory SIJ-based pain, establishing evidence-based guidelines, improving diagnostic strategies, and defining indications are imperative to support growing applications within clinical practice.
研究设计/设置：回顾性队列分析。
本研究评估美国骶髂关节（SIJ）融合术的使用情况和人口统计学趋势。
利用珍珠潜水员国家数据库，通过国际疾病分类（ICD - 9、ICD - 10）和当前手术操作术语（CPT）编码，识别出2010年至2021年间接受SIJ融合术的患者。排除创伤、恶性肿瘤或感染的指征。记录人口统计学、临床和手术特征以及年使用率。计算年度百分比变化（APC）以确定与前几年相比使用率的增加或减少。进行负二项式回归以预测2022年至2028年的后续使用率。采用卡方分析及事后比较来比较各地区与SIJ融合相关的诊断指征和临床特征的差异。对两两分析的P值应用邦费罗尼校正。
总体而言，2010年至2021年间有18032例患者（69.8%为女性，平均年龄 = 51.0 ± 13.4岁）接受了SIJ融合术。年使用率平均增长了33.5%。南方的病例占比最大（48.9%）。2022年至2028年的预测表明手术量将持续增长，从2021年的1350例总体增加1100%，到2028年底达到16195例。脊柱关节病引起的骶髂关节炎是全国最常见的诊断指征（51%）。接受SIJ融合术的患者中，18%曾接受过腰椎融合术，只有45%在术前接受了诊断性SIJ注射。
由于SIJ融合术越来越多地用于治疗基于SIJ的难治性疼痛，制定循证指南、改进诊断策略并明确指征对于支持其在临床实践中的不断应用至关重要。
