Introduction: Revision sacroiliac joint fusion (RSIJF) may be required in up to 12% of SIJF cases. Patient-reported outcomes (PROs) are lacking at extended follow-up.
Methods: All patients who underwent RSIJF with a single surgeon from 2017-2022 were retrospectively reviewed. A principles-based approach was utilized: joint cortication, bone grafting, compression, and rigid stability. Preoperative PROs, as well as at 1- and 2-year follow-up timepoints, were recorded for Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Single Assessment Numeric Evaluation (SANE), PROMIS Pain Interference (PI), and PROMIS Physical Function (PF). Fusion was assessed by CT at 1 and 2 years postoperatively.
Results: 42 rSIJF were performed in 33 patients. 23 patients (70%) were female. Mean age was 52 (range 31 – 80), and mean BMI was 27.9 (range 18.4 - 45). Average follow-up was 35 months (range 12 – 90). Eighteen patients (55%) had previous lumbar surgery (PLS). Mean (range) SANE scores were 73% (0-100%) at 1 year and 64% (0-100%) at 2 years. ODI scores improved from 55 (11-88) preoperatively to 44 (8-86) at 1 year and 47 (12-72) at 2 years, significant at both timepoints (p≤0.008). Postoperative PF scores demonstrated improvement at both timepoints (30.0 preop vs. 36.5 and 40.5 postop; p≤0.03). PI scores improved significantly from 69.5 preop to 62.3 at 2 year follow-up (p=0.03). NPRS scores at 1 year postop were lower than preop NPRS (7.1 preop vs. 4.7 and 4.3 postop; p=0.001). 2-year PF scores were significantly worse in patients with PLS (p=0.032). NPRS, SANE, and ODI scores did not differ by PLS status. Two patients underwent reoperation: one hardware removal and one revision for continued pain. Radiographic fusion rate was 100%.
Conclusion : RSIJF demonstrates sustained improvement in patient-reported outcomes at 1 and 2 years postoperatively using a principles-based approach. Improvements were moderate, highlighting a challenging diagnosis and patient population.
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