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一项关于新型骶髂关节融合装置12个月安全性和有效性的回顾性多中心分析:ACCESS研究

A Retrospective, Multicenter Analysis of a Novel Sacroiliac Joint Fusion Device on Safety and Efficacy at 12 Months: Access Study.

作者信息

Dorsi Michael J, Mehta Pankaj, Vu Chau, Boev Angel, Bailey-Classen Ashley, Moore Greg, Reece David, Abd-Elsayed Alaa, Falowski Steven, Pope Jason E

机构信息

Department of Neurosurgery, University of California Los Angeles, Westlake Village, CA 91361, USA.

Pain Specialists of America, Killeen, TX 78664, USA.

出版信息

Healthcare (Basel). 2025 Jun 28;13(13):1544. doi: 10.3390/healthcare13131544.

Abstract

: Arthrodesis of the sacroiliac joint (SIJ) has evolved over the last 5 years, with many trajectory strategies emerging. Innovation has outpaced data generation on the safety and efficacy of novel SIJ arthrodesis techniques. This retrospective review of the use of a SiLO TFX SIJ fusion system provides 12-month post-implant outcome data that can be compared with other techniques from published literature. : A retrospective analysis was performed on patients that underwent the SiLO TFX sacroiliac joint fusion procedure at eight sites with data on pain reduction and functional improvement from baseline, as measured by a numerical rating scale (NRS) and Oswestry Disability Index (ODI), along with some safety and device integrity assessments recorded at 12 months post-implant. Safety was assessed by identifying key serious adverse events (bleeding, infection, nerve injury), and device integrity was assessed by evaluating misplaced or malfunctioned devices. ODI and NRS outcomes were compared with published rates from the literature. : Between 16 March 2023 and 20 February 2024, 42 subjects with 12-month ODI data available were enrolled. The subjects had a mean age of 60 ± 11 years, and 71% were female. The mean ODI score of 33 ± 15 at baseline improved to 17 ± 11 at 12 months, with a statistically significant improvement from baseline of 16 ± 15 ( < 0.0001). Furthermore, 52% of subjects had a 15-point absolute ODI improvement. Mean NRS of 7.1 ± 2.8 at baseline improved to 2.9 ± 2.2 at 12 months with a statistically significant reduction in pain of 4.2 ± 3.4 ( < 0.0001). No key serious adverse events or device integrity complications were noted. Subgroup analyses for a cohort of subjects with baseline ODI ≥ 30 and VAS pain ≥ 50 demonstrated that performance was similar to that in previously published literature with a mean improvement in ODI of 23.3 ± 12.7 ( < 0.0001) with 78% of subjects achieving a 15-point improvement at 12 months, and mean NRS improving by 4.7 ± 3.0 ( < 0.0001) with 88.9% achieving an improvement of 2 points. : This data supports the safety and efficacy of SiLO TFX for SIJ fusion. The retrospective outcomes are comparable to those published for lateral-approach SIJ fusion. As follow up is limited to 12 months in this retrospective dataset; long-term fusion and cost-effectiveness remain to be addressed. Prospective, randomized controlled trials with a larger cohort are needed further to compare SiLO TFX to other available SIJ fusion techniques.

摘要

骶髂关节(SIJ)融合术在过去5年中不断发展,出现了多种手术策略。新型SIJ融合技术的创新速度超过了其安全性和有效性的数据生成速度。本项对SiLO TFX SIJ融合系统使用情况的回顾性研究提供了植入后12个月的结果数据,可与已发表文献中的其他技术进行比较。

对在8个地点接受SiLO TFX骶髂关节融合手术的患者进行了回顾性分析,收集了从基线开始的疼痛减轻和功能改善数据,通过数字评分量表(NRS)和Oswestry功能障碍指数(ODI)进行测量,同时记录了植入后12个月的一些安全性和器械完整性评估结果。通过识别关键的严重不良事件(出血、感染、神经损伤)来评估安全性,通过评估器械位置不当或故障来评估器械完整性。将ODI和NRS结果与文献中公布的发生率进行比较。

在2023年3月16日至2024年2月20日期间,纳入了42例有12个月ODI数据的受试者。受试者的平均年龄为60±11岁,71%为女性。基线时ODI平均评分为33±15,在12个月时改善至17±11,与基线相比有统计学意义的改善,改善值为16±15(P<0.0001)。此外,52%的受试者ODI绝对改善了15分。基线时NRS平均为7.1±2.8,在12个月时改善至2.9±2.2,疼痛有统计学意义的减轻,减轻值为4.2±3.4(P<0.0001)。未发现关键的严重不良事件或器械完整性并发症。对基线ODI≥30且视觉模拟评分(VAS)疼痛≥50的受试者亚组分析表明,其表现与先前发表的文献相似,ODI平均改善23.3±12.7(P<0.0001),78%的受试者在12个月时ODI改善了15分,NRS平均改善4.7±3.0(P<0.0001),88.9%的受试者改善了2分。

这些数据支持了SiLO TFX用于SIJ融合的安全性和有效性。回顾性结果与外侧入路SIJ融合术的已发表结果相当。由于本回顾性数据集中的随访仅限于12个月,长期融合情况和成本效益仍有待探讨。需要进行更大样本量队列的前瞻性随机对照试验,以进一步将SiLO TFX与其他可用的SIJ融合技术进行比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/141f/12250215/5f81df87a476/healthcare-13-01544-g001.jpg

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