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Abstract：
OBJECTIVE: There is conflicting evidence regarding treatment outcomes after minimally invasive sacroiliac joint fusion for long-lasting severe sacroiliac joint pain. The primary aim of our cohort study was to investigate change in patient-reported outcome measures (PROMs) after minimally invasive sacroiliac joint surgery in daily practice in the Swedish Spine Registry. Secondary aims were to explore the proportion of patients reaching a patient acceptable symptom score (PASS) and the minimal clinically important difference (MCID) for pain scores, physical function, and health-related quality of life outcomes; furthermore, to evaluate self-reported satisfaction, walking distance, and changes in proportions of patients on full sick leave/disability leave and report complications and reoperations.
METHODS: Data from the Swedish Spine Registry was collected for patients with first-time sacroiliac joint fusion, aged 21 to 70 years, with PROMs available preoperatively, at 1 or 2 years after last surgery. PROMs included Oswestry Disability Index (ODI), Numeric Rating Scale (NRS) for low back pain (LBP) and leg pain, and EQ-VAS, in addition to demographic variables. We calculated mean change from pre- to postoperative and the proportion of patients achieving MCID and PASS.
RESULTS: 68 patients had available pre- and postoperative data, with a mean age of 45 years (range 25-70) and 59 (87%) were female. At follow-up the mean reduction was 2.3 NRS points (95% confidence interval [CI] 1.6-2.9; P < 0.001) for LBP and 14.8 points (CI 10.6-18.9; P < 0.001) for ODI. EQ-VAS improved by 22 points (CI 15.4-30.3, P < 0.001) at follow-up. Approximately half of the patients achieved MCID and PASS for pain (MCID NRS LBP: 38/65 [59%] and PASS NRS LBP: 32/66 [49%]) and physical function (MCID ODI: 27/67 [40%] and PASS ODI: 24/67 [36%]). The odds for increasing the patient\'s walking distance to over 1 km at follow-up were 3.5 (CI 1.8-7.0; P < 0.0001), and of getting off full sick leave or full disability leave was 0.57 (CI 0.4-0.8; P = 0.001). In the first 3 months after surgery 3 complications were reported, and in the follow-up period 2 reoperations.
CONCLUSIONS: We found moderate treatment outcomes after minimally invasive sacroiliac joint fusion when applied in daily practice with moderate pain relief and small improvements in physical function.
METHODS: Data from the Swedish Spine Registry was collected for patients with first-time sacroiliac joint fusion, aged 21 to 70 years, with PROMs available preoperatively, at 1 or 2 years after last surgery. PROMs included Oswestry Disability Index (ODI), Numeric Rating Scale (NRS) for low back pain (LBP) and leg pain, and EQ-VAS, in addition to demographic variables. We calculated mean change from pre- to postoperative and the proportion of patients achieving MCID and PASS.
RESULTS: 68 patients had available pre- and postoperative data, with a mean age of 45 years (range 25-70) and 59 (87%) were female. At follow-up the mean reduction was 2.3 NRS points (95% confidence interval [CI] 1.6-2.9; P < 0.001) for LBP and 14.8 points (CI 10.6-18.9; P < 0.001) for ODI. EQ-VAS improved by 22 points (CI 15.4-30.3, P < 0.001) at follow-up. Approximately half of the patients achieved MCID and PASS for pain (MCID NRS LBP: 38/65 [59%] and PASS NRS LBP: 32/66 [49%]) and physical function (MCID ODI: 27/67 [40%] and PASS ODI: 24/67 [36%]). The odds for increasing the patient\'s walking distance to over 1 km at follow-up were 3.5 (CI 1.8-7.0; P < 0.0001), and of getting off full sick leave or full disability leave was 0.57 (CI 0.4-0.8; P = 0.001). In the first 3 months after surgery 3 complications were reported, and in the follow-up period 2 reoperations.
CONCLUSIONS: We found moderate treatment outcomes after minimally invasive sacroiliac joint fusion when applied in daily practice with moderate pain relief and small improvements in physical function.
摘要：
目的：关于长期严重骶髂关节痛的微创骶髂关节融合术后的治疗结果存在矛盾的证据。我们队列研究的主要目的是在瑞典脊柱注册中心的日常实践中调查微创骶髂关节手术后患者报告的结果指标（PROM）的变化。次要目的是探索达到患者可接受症状评分（PASS）的患者比例和疼痛评分的最小临床重要差异（MCID）。物理功能，以及与健康相关的生活质量结果；此外，评估自我报告的满意度，步行距离,以及病假/残疾假患者比例的变化，并报告并发症和再次手术。
方法：从瑞典脊柱登记处收集首次骶髂关节融合患者的数据，21至70岁，术前可用的PROM，在最后一次手术后1年或2年。项目包括Oswestry残疾指数(ODI)，下腰痛（LBP）和腿部疼痛的数字评定量表（NRS），和EQ-VAS，除了人口统计变量。我们计算了从术前到术后的平均变化以及达到MCID和PASS的患者比例。
结果：68例患者有可用的术前和术后数据，平均年龄45岁（25-70岁）和59岁（87％）为女性。随访时，LBP平均降低2.3个NRS点（95%置信区间[CI]1.6-2.9；P<0.001），ODI平均降低14.8点（CI10.6-18.9；P<0.001）。随访时EQ-VAS评分提高22分(CI15.4-30.3,P<0.001)。大约一半的患者在疼痛方面达到了MCID和PASS（MCIDNRSLBP：38/65[59%]和PASSNRSLBP：32/66[49%]）和身体功能（MCIDODI：27/67[40%]和PASSODI：24/67[36%]）。随访时增加患者步行距离超过1km的几率为3.5(CI1.8-7.0;P<0.0001),休完全病假或完全残疾假的人数为0.57（CI0.4-0.8；P=0.001）。在手术后的前3个月，报告了3种并发症，并在后续阶段进行2次再手术。
结论：我们发现微创骶髂关节融合术在日常实践中应用时，治疗效果中等，疼痛中度缓解，身体功能略有改善。
方法：从瑞典脊柱登记处收集首次骶髂关节融合患者的数据，21至70岁，术前可用的PROM，在最后一次手术后1年或2年。项目包括Oswestry残疾指数(ODI)，下腰痛（LBP）和腿部疼痛的数字评定量表（NRS），和EQ-VAS，除了人口统计变量。我们计算了从术前到术后的平均变化以及达到MCID和PASS的患者比例。
结果：68例患者有可用的术前和术后数据，平均年龄45岁（25-70岁）和59岁（87％）为女性。随访时，LBP平均降低2.3个NRS点（95%置信区间[CI]1.6-2.9；P<0.001），ODI平均降低14.8点（CI10.6-18.9；P<0.001）。随访时EQ-VAS评分提高22分(CI15.4-30.3,P<0.001)。大约一半的患者在疼痛方面达到了MCID和PASS（MCIDNRSLBP：38/65[59%]和PASSNRSLBP：32/66[49%]）和身体功能（MCIDODI：27/67[40%]和PASSODI：24/67[36%]）。随访时增加患者步行距离超过1km的几率为3.5(CI1.8-7.0;P<0.0001),休完全病假或完全残疾假的人数为0.57（CI0.4-0.8；P=0.001）。在手术后的前3个月，报告了3种并发症，并在后续阶段进行2次再手术。
结论：我们发现微创骶髂关节融合术在日常实践中应用时，治疗效果中等，疼痛中度缓解，身体功能略有改善。
