Simultaneous Sacroiliac Joint Fusion in Patients with Long Lumbosacral Constructs: Case Report and Operative Technique

Abstract

Background: Literature data on the frequency and pathogenesis of sacroiliac joint (SIJ) pain and arthropathy following lumbosacral fusion with long constructs combined with sacroiliac fixation remains scarce. From clinical experience, we noticed that many patients undergoing these surgeries develop SIJ disease postoperatively.

Case description: We report a clinical observation of no occurrence or remission of SIJ pain following simultaneous SIJ fusion in cases of long-construct lumbosacral fusion and sacropelvic fixation with S2-alar-iliac screws. An illustrative case and description of the simultaneous SIJ fusion technique are discussed as well.

Conclusions: Based on our experience, we believe that fusing the SIJ simultaneously during sacropelvic fixation in the context of a long lumbosacral fusion surgery may lead to a decline in the incidence of SIJ disease, as well as remission of SIJ pain in patients requiring revision surgeries. Future, multicenter prospective studies are needed to test and validate this observation.

Keywords: Fusion; Long construct; Lumbosacral fusion; S2-alar-iliac screw; Sacroiliac joint; Sacroiliitis; Sacropelvic fixation.