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术前定位的同种异体骨后入路骶髂关节融合术

Posterior allograft sacroiliac joint fusion with pre-operative mapping.

作者信息

Bovinet Chris, Moghim Robert, Jin Max Y, Abd-Elsayed Alaa

机构信息

The Spine Center of SE Georgia, Brunswick, GA, USA.

Colorado Pain Care, Denver, CO, USA.

出版信息

Interv Pain Med. 2025 Apr 4;4(2):100581. doi: 10.1016/j.inpm.2025.100581. eCollection 2025 Jun.

Abstract

BACKGROUND

Low back pain is a highly prevalent and disabling condition. Sacroiliac joint dysfunction is prevalent in up to 62 % of some populations and is a common origin of low back pain. The posterior approach for minimally invasive sacroiliac joint fusion with an allograft is still relatively novel, with limited studies examining its safety and efficacy.

OBJECTIVE

The objective of our study was to analyze changes in pain and opioid usage for patients who underwent this procedure with pre-operative mapping after exhausting conservative treatment methods.

METHODS

This was a single-center, retrospective study with all cases completed by a single interventional pain physician. Outcomes regarding pain and opioid usage were extracted from electronic medical records, Georgia Prescription Drug Monitoring Program reports, and all other available state databases for 208 consecutive patients who underwent the minimally invasive sacroiliac joint fusion procedure with the LinQ Fusion Implant (PainTeq, Tampa, FL) after pre-operative mapping between August 2019 and October 2022. Pain was assessed using the Numerical Rating Scale (NRS), and opioid consumption was measured using Morphine Milligram Equivalents (MME).

RESULTS

NRS scores decreased from 7.23 ± 1.82 at baseline to 1.16 ± 1.35 at the final available follow-up (p < 0.001). Pain improvements ranged from 40 to 100 %, and all patients reported at least some improvement post-intervention. 205 of the 208 patients reported an improvement in pain of at least 50 %. MME reduced from 20.74 ± 26.33 mg to 10.00 ± 18.69 mg (p < 0.001).

CONCLUSION

Posterior allograft sacroiliac joint fusion significantly reduces pain and opioid consumption. Pre-operative mapping is beneficial but requires more evidence to elucidate its role in optimizing implant placement.

摘要

背景

下腰痛是一种高度流行且使人致残的病症。骶髂关节功能障碍在某些人群中的患病率高达62%,是下腰痛的常见病因。采用同种异体移植物进行微创骶髂关节融合的后路手术仍然相对新颖,对其安全性和有效性的研究有限。

目的

我们研究的目的是分析在保守治疗方法用尽后接受了这种术前定位手术的患者的疼痛和阿片类药物使用情况的变化。

方法

这是一项单中心回顾性研究,所有病例均由一名介入疼痛科医生完成。从电子病历、佐治亚州处方药监测计划报告以及所有其他可用的州数据库中提取了208例在2019年8月至2022年10月期间接受了使用LinQ融合植入物(PainTeq,坦帕,佛罗里达州)进行术前定位的微创骶髂关节融合手术的连续患者的疼痛和阿片类药物使用情况的结果。使用数字评分量表(NRS)评估疼痛,使用吗啡毫克当量(MME)测量阿片类药物消耗量。

结果

NRS评分从基线时的7.23±1.82降至最后一次可用随访时的1.16±1.35(p<0.001)。疼痛改善幅度为40%至100%,所有患者均报告干预后至少有一定程度的改善。208例患者中有205例报告疼痛改善至少50%。MME从20.74±26.33毫克降至10.00±18.69毫克(p<0.001)。

结论

后路同种异体移植物骶髂关节融合术可显著减轻疼痛和减少阿片类药物消耗。术前定位有益,但需要更多证据来阐明其在优化植入物放置中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7868/12002818/7326ec1da721/gr1.jpg

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