Background. SI joint pain is difficult to diagnose due to overlapping symptoms of the lumbar spine, and until recently, treatment options have been limited. The purpose of this retrospective study is to report on the safety and effectiveness of MIS SI joint arthrodesis using a series of triangular, porous plasma coated implants in patients refractory to conservative care. Methods. We report on the first 40 consecutive patients with one-year follow-up data that underwent MIS SI joint fusion with the iFuse Implant System (SI-BONE, Inc., San Jose, CA) by a single surgeon. Medical charts were reviewed for demographics, perioperative metrics, complications, pain scores, and satisfaction. Results. Mean age was 58 years (range 30–81) and 75% of patients were female. Postoperative complications were minimal and included transient trochanteric bursitis (5%), facet joint pain (20%), and new low back pain (2.5%). There were no reoperations at one year. Mean pain score improved from 8.7 (1.5 SD) at baseline to 0.9 (1.6) at 12 months, a 7.8-point improvement ( ). Patient satisfaction was very high. Conclusions. The results of this case series reveal that MIS SI joint fusion using the iFuse Implant System is a safe and effective treatment option in carefully selected patients. 1. Background Low back pain (LBP) is exceedingly common in modern society, affecting well over 90% of adults at some point in their lives [1]. Apart from the common cold, it is the most common reason for visits to the primary care doctor [1]. Loss of productivity and income combined with medical expenses results in a $60 billion expenditure annually in the US related to low back pain [2]. Successful treatment of low back pain demands identifying the pain generator(s), which can be a significant challenge due to the multifactorial nature of this condition. In the early 1900s, the sacroiliac (SI) joint was suspected as a significant generator of LBP. Over time, as more reliably diagnosed conditions such as herniated discs and facet arthropathy became better understood, less focus was placed on the SI joint [3]. Recently there has been a resurgence in consideration of the SI joint as a low back pain generator. Recent published literature reports that 15–30% of patients presenting with low back pain had SI joint problems [4]. Additionally, up to 75% of postlumbar fusion patients will develop significant SI joint degeneration after 5 years [5–7]. SI joint pain can mimic discogenic or radicular low back pain, and patients can present with low back, groin, and/or gluteal pain, leading to the potential
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