Sacroiliac joint fusion with fibular bone graft in patients with failed percutaneous iliosacral screw fixation

Abstract

Background: Numerous studies have described screw fixation of sacroiliac (SI) joint, but there have been very few reports in the literature regarding long-term pain levels after SI joint fixation and their management. The objective of this study was to analyze the results of SI joint fusion with fibular bone graft in patients with persistent late pain after iliosacral screw fixation. Methods: Eleven consecutive patients with persistent late pain following iliosacral screw fixation with failed conservative methods were managed with fibular bone grafting of the SI joint. The patients were followed up at 2, 6, 12, 24 weeks and every 3 months thereafter. They were clinically assessed for pain, infection, and ambulation. Results: The average duration of follow-up was 18 months. There were neither intraoperative complications nor postoperative wound infection. Eight patients were pain free and returned to their work. The remaining three patients were having persistent-localized pain, but they were able to manage their daily activities. Conclusions: Fibular graft is feasible and apparently effective choice for SI joint fusion. This procedure avoids further metal work, which results in successful fusion and pain relief as well as stabilizing the SI joint. Copyright © 2010 by Lippincott Williams & Wilkins.