Sacroiliac Joint Fusion: A Comparison of Minimally Invasive Navigation-assisted And robotic-guided Techniques

Introduction: The sacroiliac joint (SIJ) stabilizes the spine and transfers forces between the spine and pelvis.
SIJ dysfunction, a frequently underdiagnosed cause of low back pain, remains understudied. SIJ
fusion aims to stabilize the joint, reduce abnormal motion, and alleviate pain. Minimally invasive
methods, including navigation and robotic technology, are gaining popularity for their lower
surgical risks. We compare institutional navigation-assisted SIJ fusion (NA) and robotic-guided
SIJ fusion (RA) outcomes.

Methods: We retrospectively reviewed demographic data (age, sex, BMI, number of previous spinal
surgeries) of adult patients who underwent SIJ fusion at our institution from November 2022 to
September 2024. We analyzed preoperative, post-anesthesia care unit (PACU), and postoperative
pain scores to calculate percentage pain changes. Additionally, we compared surgical details
(number of screws, operating room (OR) times, 30-day complications, and follow-up duration)
between NA and RA groups.

Results: Our study identified 29 patients who underwent SIJ fusion during the study period: 19 with NA
and 10 with RA. Both cohorts were comparable at baseline in age (p=0.416), BMI (p=0.478),
and prior surgeries (p=0.879). The group comprised 18 females and 11 males, with an average
age of 65. The NA cohort had a 10.3% improvement in their pain scores while the RA group had
31.0% improvement (p=0.52). OR time was significantly longer in the RA group (p < 0.001) and
number of screws placed laterally was comparable across groups (p=0.106). Both groups also
had similar 30-day postoperative outcomes (p=0.575).

Conclusion : While there was no statistically significant difference between the groups, a trend toward lower
postoperative pain scores in the RA group was observed. The extended operative time in the RA
group is attributable to the new technique at our hospital. Limitations of our study include the
retrospective design, the small number of SIJ fusion patients, and the relatively short follow-up
data in both groups.