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Study Design  Retrospective case series.    Purpose  To report a novel approach to open posterior sacroiliac (SI) joint arthrodesis using a threaded titanium cage containing rhBMP­-2.    Materials & Methods  Twenty consecutive patients with a mean age of 57.7 years (range: 33­-84) underwent posterior SI joint fusion. Two closely related novel posterior oblique approaches were employed. Enrolled subjects included 17 females and three males. The mean follow­-up time for CT to assess fusion was 27 months (range: 17­-45 months). Insurance included a mixture of public and private payers. One of the patients (patient 19) was on worker’s compensation. During follow-­up, patients were assessed radiologically for radiographic bony union and asked to rate their satisfaction with the procedure. The Oswestry Disability Index (ODI) was applied on a one-time basis upon follow-up. All patients were diagnosed with sacroiliac joint pain based primarily on a positive response to fluoroscopically guided injections into the sacroiliac joint.    Results  Out of 20 patients, 33 SI joints were considered symptomatic and operated, and 32/33 joints successfully fused radiographically (a 96.9% fusion success rate). The average procedure satisfaction rating (PSR) was 7.25 out of a maximum 10 (range 1­-10). Seventeen patients responded to post-surgery ­follow-up questions, and 13 patients (76%), indicated they would elect to have the surgery again as well as recommend it to others. Average estimated blood loss was less than 50 mL, and average length of stay was one day.    Conclusions  Preliminary experiences with these novel posterior approaches to the SI joint described here seem to be safe and effective. The novel posterior approaches to the SI joint described here appear, preliminarily, to have many advantages over previously described procedures including markedly reduced surgical morbidity.

A Retrospective Outcomes Study of 20 Sacroiliac Joint Fusion Patients