A prospective study was conducted to determine the functional and radiographic outcome of sacroiliac arthrodesis. Twenty patients were enrolled and the mean follow-up period was 4.6 years. SI joint instability was the most common etiology. Seventeen of twenty patients (85%) went on to a solid fusion. Statistically significant improvement was noted postoperatively in five of eight SF-36 categories (PF, RP, BP, SF, and RE), with a positive trend in the others. We conclude that sacroiliac arthrodesis is successful in the treatment of sacroiliac disorders, however its success is dependent on careful patient selection.

The purpose of this study was to determine the functional and radiographic outcome of sacroiliac joint arthrodesis.

Twenty consecutive patients were enrolled with an average age of 45.1 years. Plain radiographs and SF-36 Health Surveys were obtained prior to surgery and during the follow-up period.

Mean duration of symptoms was 2.6 years and mean follow-up was 4.6 years. SI joint instability was the most common etiology and was present in twelve patients. Seventeen of Twenty (85%) patients went on to a solid fusion. Of the three patients who did not fuse, two remained symptomatic and required revision surgery. Fifteen of twenty patients (75%) completed pre- and post-operative SF-36 forms. Improvement was noted in all SF-36 categories. PF improved from 31.8±31.0 to 50.7±34.5 (p< 0.030). RP improved from a 0.0±0.0 to 31.3±41.5 (p< 0.012). BP improved from 15.6±11.1 to 35.7±24.7 (p< 0.009). SF improved from 37.5±21.0 to 61.5±24.1 (p< 0.028). Finally, RE improved from 46.2±48.2 to 66.7±44.9 (p< 0.012). Improvement was also noted in GH, VT, and MH from 52.2±23.5, 30.8±21.7, and 56.0±28.3, respectively to 56.1±20.5, 44.6±25.8, and 61.3±26.3, respectively, however these were not significant (p values 0.345, 0.064, and 0.220, respectively).

In this prospective study, a fusion rate of 85% was achieved, and statistically significant improvement in functional outcome was observed in five of eight SF-36 categories with a positive trend in the others.

Sacroiliac arthrodesis is successful in the treatment of SI joint instability, arthritis, spondyloarthropathy, and dysfunction, however, its success is dependent on careful patient selection.

Introduction and Aims: Although PD has characteristic findings and stages of progression, neither the nature of operative spine problems occurring in patients with PD, nor their peri-operative complications, have been presented previously.

Method: In this retrospective observational case series, we describe the nature of operative spine problems in patients with Parkinson’s disease (PD), and evaluate the incidence and types of peri-operative complications in spine surgery for patients with PD. A retrospective chart review was performed on 24 consecutive PD patients undergoing spine surgery in a six-year span at one institution. Nineteen were first surgeries, and five were first seen as failed back syndrome from surgery done elsewhere.

Results: The mean patient age was 69 years. Spinal stenosis (10 patients) and cervical myelopathy (4 patients) were the predominant pre-operative diagnoses for the primary surgeries, with three patients operated upon for kyphoscoliosis (16%) and two for other conditions. Minor or transient complications were common, including delirium, arrhythmia, deep vein thrombosis, and dural tear; there were also two significant PD-specific complications, including aspiration pneumonia and global motor paresis post-operatively. Four of 19 primary cases were revised for recurrent stenosis (two patients) or pseudarthrosis (two patients). The overall number of poor patient-reported outcomes was only two of 14 primary cases (five patients had inadequate outcome measures) and zero of seven revisions (two had inadequate outcome measures), at a mean follow-up of 19 months.

Conclusion: Symptoms and functional deficits of spinal disease were often masked by PD, posing diagnostic difficulty. However, outcomes and complications of spine surgery were similar to those of non-PD patients at the same institution. Spine symptoms improved concomitantly with successful surgery unless the PD progressed or significant complications ensued.