Disclosures: GIUSEPPE PAESE, DO: No financial relationships or conflicts of interest

Case Diagnosis: Sacroiliitis, Sacroiliac Joint Instability

Case Description: This case report demonstrates the efficacy of a new SI joint fusion technique which achieves fusion by distraction of the joint rather than compressing it. We were able to compare the results of both procedures which were performed sequentially on contralateral SI joints of the patient in question. SI joint dysfunction is a commonly overlooked diagnosis in patients presenting with chronic low back pain. This condition is often unresponsive to injections and rhizotomies in the long term, leaving joint fusion as the standard definitive solution for pain relief. The traditional method for SI joint fusion is an invasive surgery performed by orthopedic surgeons, utilizing hardware to compress and immobilize the joint. This new method involves distraction of the joint and implantation of bone allograft for fusion. It is a minimally invasive procedure which can be performed by pain medicine specialists at an outpatient surgery center. The parameters used to compare the two methods are pain reduction on a scale from 0 to 10, functionality, opioid usage and recovery time at specific intervals after the two procedures. Data was gathered through patient interviews and past medical records.

Setting: Outpatient Clinic; Ft. Lauderdale, FLAssessment/

Results: Following the later fusion, the patient demonstrated a marked decrease in pain, decreased opioid usage and improved functionality at all intervals with a shorter recovery period compared to her prior fusion.

Discussion: To our knowledge, this is the first documented case of a patient having bilateral SI joint fusions with both methods.

Conclusion: It is our opinion that fusing the SI joint by means of insertion of bone allograft into a wide graft window following joint distraction will yield better outcomes when compared to more traditional techniques which compress the joint via hardware placement.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/sacroiliac-joint-fusion-compression-vs-distraction-a-case-study/