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Incidence, diagnosis and management of sacroiliitis after spinal surgery: a systematic review of the literature.

Authors
  • Colò, G1
  • Cavagnaro, L2
  • Alessio-Mazzola, M3
  • Zanirato, A3
  • Felli, L3
  • Formica, M3
  • 1 Clinica Ortopedica - IRCCS Ospedale Policlinico San Martino, Università di Genova, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy. [email protected] , (Italy)
  • 2 Ortopedia e Traumatologia 2 - Joint Replacement Unit - Ospedale Santa Corona, Viale 25 Aprile, 38, 17027, Pietra Ligure, SV, Italy. , (Italy)
  • 3 Clinica Ortopedica - IRCCS Ospedale Policlinico San Martino, Università di Genova, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy. , (Italy)
Type
Published Article
Journal
Musculoskeletal surgery
Publication Date
Aug 01, 2020
Volume
104
Issue
2
Pages
111–123
Identifiers
DOI: 10.1007/s12306-019-00607-0
PMID: 31065955
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The sacroiliac joint (SIJ) is a possible source of persistent or new onset pain after lumbar or lumbosacral fusion. The aim of this paper is to systematically review and analyze the available literature related to the incidence, diagnosis and management of sacroiliitis after spinal arthrodesis. The authors independently screened the titles and abstracts of all articles identified concerning sacroiliac joint pain after lumbar or lumbosacral fusion, to assess their suitability to the research focus. The average incidence of sacroiliitis after lumbar or lumbosacral arthrodesis was found to be 37 ± 28.48 (range 6-75), increasing directly to the number of fused segments involved, especially when the sacrum is included. The most accurate evaluation is the image-guided injection of anesthetic solutions in the joint. Surgery treatment may be considered when conservative therapy fails, with open surgery or with minimally invasive SIJ fusion. Although the risk of developing SIJ degeneration is unclear, the results indicate that pain and degeneration of SIJ develop more often in patients undergoing lumbosacral fusion regardless of the number of melting segments. The treatment of sacroiliitis appears to be independent of his etiology, with or without previous instrumentation on several levels.

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