1623. Minimally Invasive Sacroiliac Joint Fusion Using a Novel Hydroxyapatite-Coated Screw: Two-Year Clinical and Radiographic Outcomes

Authors: Charles Ledonio; Louis Rappoport, MD; Torrey Shirk; Jessica Riggleman, BS (Audubon, PA)

Introduction: The proper diagnosis and treatment of sacroiliac joint (SIJ) pain remains a clinical challenge. Dysfunction of SIJ can produce pain in the lower back, buttocks, and extremities. Triangular titanium implants for minimally invasive SIJ fusion have achieved visual analog scale (VAS) and Oswestry Disability Index (ODI) improvements in 83% of patients compared to non-surgical management in a randomized clinical trial. This study reports on a novel hydroxyapatite-coated titanium screw for surgical treatment of SIJ dysfunction. Methods: Data were prospectively collected on 43 consecutive patients who underwent minimally invasive SIJ fusion with a novel hydroxyapatite-coated screw. Clinical assessments and radiographs were collected and evaluated at 12 and 24 months postoperatively. Results: Mean patient age was 54.2 ± 10.4 years, and 65.1% of patients were female. Mean operative time was 39.2 ± 18.9 minutes, and estimated blood loss did not exceed 50cc. Overnight hospital stays were required for 88.4% of patients, while remaining patients needed a 2-day stay. Mean preoperative VAS back, left, and right leg pain scores decreased significantly by 26.3, 25.1, and 25.5 points respectively at 12 months postoperatively ( p < 0.01) and by 30.1, 27.0, and 26.3 points respectively at 24 months postoperatively ( p < 0.01). ODI scores significantly decreased by a mean of 21.9 points at 12 months and 28.3 points at 24 months ( p < 0.01 ). All patients who were preoperatively employed returned to work within 3 months. Two patients who required revision surgery reported symptom improvement within 3 weeks and did not require subsequent surgery. Conclusion: SIJ fusion using a hydroxyapatite-coated screw to treat SIJ dysfunction significantly decreased VAS back and leg pain and ODI scores at 1 year and remained durable at 2-year follow-up.