"A minimally invasive implant procedure is highly effective in reducing pain and disability for patients with sacroiliac joint SIJ dysfunction reports a clinical trial in the November issue of Neurosurgery http official journal of the Congress of Neurological Surgeons http published by Wolters Kluwer http The randomized controlled trial shows superior outcomes in patients undergoing minimally invasive sacroiliac joint SIJ fusion using triangular titanium implants compared to nonsurgical management according to the new research overseen by Dr. Daniel J. Cher of SIBONE Inc. in San Jose Calif. The study was sponsored by SIBONE manufacturer of the SIJ implants. Good Pain Relief and Other Outcomes with Implant Treatment for SIJ Dysfunction  The study included  patients with low back pain caused by confirmed SIJ dysfunction treated at  US spine surgery clinics. The SIJ connects the central sacrum and lateral ilium bones of the pelvis. SIJ disruption or osteoarthritis is a common pain condition estimated to cause  to  percent of cases of chronic low back pain. Trial subjects had severe SIJ pain with an average pain score of  on a topoint scale. Average pain duration was longer than six years and about twothirds of subjects were taking opioid narcotic medications. Many had previously received many nonsurgical SIJ treatments and many had a history of prior spinal surgery. Twothirds of subjects were randomly assigned to undergo minimally invasive SIJ fusion. In this procedure triangular titanium implants were placed through a small incision to stabilize and fuse the SIJ. Procedures were unilateral in most cases but some subjects underwent bilateral treatment. The remaining subjects received nonsurgical treatments such as physical therapy steroid injections andor radiofrequency ablation of sacral nerve root lateral branches. Pain and other outcomes were compared at baseline and at    and  months. At  months subjects in the nonsurgical group had the option to cross over to the implant procedure. Based on reduction in pain and absence of complications at  months treatment was rated successful in  percent of subjects assigned to the SIJ implant procedure compared to  percent with nonsurgical treatment. Average pain score decreased to  in the surgical group versus  in the nonsurgical group. Seventythree percent of subjects undergoing the implant procedure had clinically significant reduction in disability scores compared to just  percent in the nonsurgical group. After one year subjects assigned to SIJ fusion still had significant reductions in pain and disability as well as improved quality of life. Thirtyfive subjects from the nonsurgical group opted to undergo the implant procedure with similarly good results. There were only a few complications related to the SIJ implant procedure. Sacroiliac joint dysfunction is a common cause of disabling pain in the lower back buttocks or groin. Many different surgical and nonsurgical treatments have been used for this condition despite a lack of highquality evidence for their effectiveness. The minimally invasive SIJ implant approach evaluated in this trial has been cleared by the US Food and Drug Administration. The study is the first randomized controlled trial to directly compare the results of surgical and nonsurgical treatment for SIJ dysfunction. The results show clinically and statistically important improvements in clinical outcomes for patients undergoing the SIJ implant procedure according to Dr. Cher and colleagues with profound differences between the surgical and nonsurgical groups. The implant procedure is minimally invasive has few complications and produces significant and lasting improvements in pain disability and quality of life. The authors note some important limitations of the trial including the lack of longterm outcomes in the nonsurgical group due to the high crossover rate. They plan further analyses including twoyear followup CT scans and a costeffectiveness comparison of SIJ fusion versus nonsurgical treatment.  Click here to read Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical Management for Sacroiliac Joint Dysfunction Month Outcomes. httpjournals.lww.comneurosurgeryFulltextRandomized_Controlled_Trial_of_Minimally_Invasive..aspx Article Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion Using Triangular Titanium Implants vs Nonsurgical Management for Sacroiliac Joint Dysfunction Month Outcomes doi .NEU.  About Neurosurgery  Neurosurgery http the Official Journal of the Congress of Neurological Surgeons http is your most complete window to the contemporary field of neurosurgery. 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