Journal
EUROPEAN SPINE JOURNAL
Volume 31, Issue 3, Pages 710-717Publisher
SPRINGER
DOI: 10.1007/s00586-021-07031-8
Keywords
Sacroiliac joint fusion; Minimally invasive; MIS; Sacroiliac joint pain; SIJ
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Our study suggests that unique postoperative complications specific to preoperative diagnosis and surgical approach exist after SIJ fusion, with higher rates of novel post-procedural pain, lumbar pathology, non-elective readmission, and infection associated with the open approach in certain diagnoses.
Purpose Two main surgical approaches are available for fusing the sacroiliac joint (SIJ): an open or minimally invasive (MIS) approach. The purpose of this study was to analyze the associated total hospital charges and postoperative complications of the MIS and open approach. Methods Using the 2016 and 2017 National Readmission Database, we conducted a retrospective cohort analysis of 2521 patients who received a SIJ fusion with an open (N = 1990) or MIS (N = 531) approach for diagnosed sacrum pain, sacroiliitis, sacral instability, or spondylosis. Each cohort was analyzed for postoperative complications. Results We identified 604 patients diagnosed with sacrum pain, 1142 with sacroiliitis, 315 with spondylosis, and 288 with sacral instability. Patients who received the open approach for sacrum pain had significantly higher rates of novel post-procedural pain (p = 0.045) and novel lumbar pathology (p = 0.015) within 30 days. On 30-day follow-up, patients with sacroiliitis treated with open SIJ fusion had significantly higher rates of novel postprocedural pain compared to those treated with MIS fusion (p = 0.045). Patients who received the open approach for spondylosis resulted in significantly higher rates of non-elective readmission within 30 days compared to the MIS approach (p < 0.0001). In addition, the open technique for spondylosis resulted in significantly higher rates of non-elective readmissions for infection within 30 days (p = 0.014). On 30-day follow-up, patients with sacral instability treated with open SIJ fusion had significantly higher rates of UTI (p = 0.045). Conclusion Our study suggests that there exist unique postoperative complications that arise after SIJ fusion specific to preoperative diagnosis and surgical approach.
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