439 - Prevalence of Minimally Invasive Sacroiliac Joint Fusions and Site of...

#439 Prevalence of Minimally Invasive Sacroiliac Joint Fusions and Site of Service

MIS Techniques and Outcomes

Poster Presented by: M. Lorio

Author(s):

M. Lorio (1)
D.W. Polly (2)
G. Andresson (3)

(1) NeuroSpine Solutions, Bristol, TN, United States
(2) University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, United States
(3) Rush University Medical Center, Chicago, IL, United States

Abstract

Introduction: Sacroiliac Joint (SIJ) Fusion is emerging as a well-accepted treatment option for SIJ disruption or sacroiliitis that has failed conservative management. Over the last 4 years technologies have emerged that allows fusion of the SIJ using Minimally Invasive (MIS) techniques, resulting in reduced blood loss and complications, faster return to activities of daily living, and reduced hospital stay. Prior to the development of these minimally invasive techniques, traditional open approach was the only option. This study aims to determine the prevalence of MIS SIJ fusion procedures among surgeons.

Methods: International Society for the Advancement of Spine Surgery (ISASS) and Society for Minimally Invasive Spine Surgery (SMISS) conducted an internet-based survey of their members to determine key variables to support a Category I CPT application for MIS SIJ arthrodesis. The surgeons included members of ISASS and SMISS. Surgeons who have not performed a SIJ fusion were excluded. Survey included number of open &MIS procedures performed annually (2009-2012), site of service, and average length of stay (ALOS).

Results: Total survey population was 2,200. Of 212 respondents, 121 were eligible. MIS procedures increased from 39% (99/256) in 2009 to 87% (889/1022) in 2012. Conversely, Open procedures decreased from 152 in 2009 to 123 in 2012. 97% of Open procedures were hospital inpatient based. 78% of MIS procedures were inpatient-based, while 15% were outpatient-based, with 6% in ambulatory surgical centers. ALOS for MIS is 1.69 days vs 4.3 days for Open. 80% of the respondents said “No”, if the Open procedure were the only option available for patients with SI joint conditions other than major traumas.

Conclusion: Arthrodesis of the SI joint is becoming a more viable treatment option. Data supports that the progression of the surgical technique to a less invasive approach has provided surgeons with a viable option for treatment of patients with sacroiliitis and SIJ disruption. The growth of MIS techniques substantiates that this procedure is becoming well a well accepted treatment option.