使用Trident™螺钉系统进行骶髂关节外侧融合术的疗效:一项回顾性分析。

Efficacy of Lateral Sacroiliac Joint Fusion With the Trident™ Screw System: A Retrospective Analysis.

作者信息

Abbasi Hamid, Moore Dominic, Rusten Mitch A, Zhan Jiawen, Sima Adam, Lightbourn Twanesha

机构信息

Spine Surgery, Avicenna Technical University and Inspired Spine Health, Burnsville, USA.

Spine Surgery, Inspired Spine Health, Burnsville, USA.

出版信息

Cureus. 2025 Jan 21;17(1):e77793. doi: 10.7759/cureus.77793. eCollection 2025 Jan.

Abstract

Background Chronic lower back pain is a significant global health issue, leading to disability and a substantial economic burden. A considerable number of cases are associated with the sacroiliac joint (SIJ), especially among patients with a history of lumbar fusions. Despite various treatments, persistent SIJ pain often requires surgical intervention, with minimally invasive techniques becoming the standard due to their benefits over open surgery. This study examines the clinical outcomes of a novel minimally invasive SIJ fixation technique using the Trident™ system. Methodology The study retrospectively reviewed 39 patients who underwent SIJ fusion with the Trident™ system across four surgical sites by a single surgeon. Strict inclusion and exclusion criteria ensured a homogeneous patient population. The procedure involved placing hollow fenestrated screws in a tri-pronged fashion across the SIJ to achieve fusion. The Oswestry Disability Index (ODI) was used to measure functional outcomes, and statistical analyses were conducted to assess the efficacy of the procedure. Results The study found statistically significant improvements in most ODI categories postoperatively. Subgroup analyses revealed that patients with bilateral SIJ fusions showed the greatest improvement, while those with unilateral fusions without prior lumbar surgery showed the least improvement, though still significant. The results suggest that the Trident™ system is effective in improving patient outcomes. Conclusions Evidence indicates that the novel SIJ fixation technique could influence future standards of care for SIJ-related chronic low back pain. The Trident™ Screw System's minimally invasive approach to SIJ fusion is effective in improving functional outcomes for patients with chronic SIJ-related lower back pain. The technique's efficacy, demonstrated through significant ODI improvements, supports its potential as a valuable treatment option.

摘要

背景 慢性下腰痛是一个重大的全球健康问题,会导致残疾和巨大的经济负担。相当一部分病例与骶髂关节(SIJ)有关,尤其是在有腰椎融合病史的患者中。尽管有各种治疗方法,但持续性骶髂关节疼痛通常需要手术干预,由于微创手术比开放手术更具优势,因此微创手术技术已成为标准术式。本研究探讨了使用Trident™系统的新型微创骶髂关节固定技术的临床疗效。

方法 本研究回顾性分析了由一名外科医生在四个手术地点为39例患者采用Trident™系统进行骶髂关节融合术的情况。严格的纳入和排除标准确保了研究对象的同质性。该手术包括以三叉戟状方式在骶髂关节上放置空心开窗螺钉以实现融合。采用Oswestry功能障碍指数(ODI)来衡量功能结果,并进行统计分析以评估该手术的疗效。

结果 研究发现术后大多数ODI类别均有统计学上的显著改善。亚组分析显示,双侧骶髂关节融合的患者改善最大,而未进行过腰椎手术的单侧融合患者改善最小,尽管仍有显著改善。结果表明Trident™系统在改善患者预后方面是有效的。

结论 有证据表明,这种新型骶髂关节固定技术可能会影响未来与骶髂关节相关的慢性下腰痛的护理标准。Trident™螺钉系统用于骶髂关节融合的微创方法对于患有慢性骶髂关节相关下腰痛的患者在改善功能结果方面是有效的。通过ODI的显著改善所证明的该技术的疗效,支持了其作为一种有价值的治疗选择的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83c7/11842032/513235f21c8c/cureus-0017-00000077793-i02.jpg

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