Study questions use of fusion surgery for treating sacroiliac joint pain

Editor's Note

A recent double-blind, randomized controlled trial could not prove that minimally invasive sacroiliac joint fusion was any more effective than sham surgery in treating severe sacroiliac joint pain. “With these findings, there should be discussion in the medical community whether an irreversible surgical procedure with related risks and complications is worth doing when the measured efficacy of surgery is so small, and a placebo effect might be a large part of that measured efficacy,” researchers wrote.

The study was published January 31 in eClinical Medicine, which is part of The Lancet Discovery Science. It involved 63 patients, 32 in the surgical group and 31 in the sham group, from two university hospitals in Sweden and Norway. In sham surgery, a blunt guide pin was inserted to the cortical ilium and removed, as if implants had been inserted.

Patients completed questionnaires and functional tests at baseline, before diagnostic injection, preoperatively, postoperatively, at three months and at six months. The mean reduction in the operated sacroiliac joint from baseline to six months postoperative was 2.6 Numeric Rating Scale points in the surgical group and 1.7 points in the sham group (mean between groups difference −1.0 points; 95% CI, −2.2 to 0.3; p = 0.13).