Introduction. Treatment of patients with SI joint pain is mostly limited to conservative care. However, in those with chronic pain and consequently prolonged mobilisation, internal fixation of the SI joint is often indicated. The aim of the present study was to assess stability and bone ingrowth of minimally invasive SI joint arthrodesis using a series of triangular, porous plasma coated implants (iFuse Implant System) using SPECT/CT. Material. We report ten cases of SI joint arthrodesis with a novel MIS SI joint fusion system. SPECT/CT was performed in all cases after a mean time of 5.8 months to evaluate bony ingrowth and stability within the SI joint. Results. In eight cases, no or only low tracer uptake could be visualized as an indicator of stability and bone ingrowth. Two patients have increased tracer uptake due to a second trauma-related ipsilateral sacral fracture and a low-grade infection. Conclusion. We could visualize satisfying osseous integration as well as stability within the SI joint after arthrodesis using iFuse Implant System. Therefore iFuse Implant System seems to be an effective treatment option in selected patients. 1. Introduction Low back pain is a common disorder, affecting up to 70% of the population at some time point during their life span [1]. It is the most common cause for inability to work in patients younger than 45 years [1, 2]. In some cases low back pain is thought of as an idiopathic disorder. However, the sacroiliac (SI) joint can often be identified as source of pain [3–5]. In patients with low back pain, the prevalence of SI joint pain ranges between 15% and 30%, as has been established upon clinical evaluation and controlled fluoroscopy SI infiltration [3–5]. The identification of the SI joint as the source of pain is a significant diagnostic challenge. Most commonly, pain deriving from the SI joint manifests as discogenic or radicular low back pain. But it may present as hip, pelvic, gluteal, sacral, or groin pain as well [2, 6]. History and physical examinations still are the keystones to diagnostic work-up as in many cases no objective findings are present on X-ray, CT, and/or MRI. Furthermore, fluoroscopically guided SI infiltration can be helpful in cases were no objective findings were found. Primary treatment options focus on physical therapy and medication optimization. Other options are infiltration with local anaesthetics. In patients with chronic pain and consequently prolonged mobilisation, an internal fixation of the SI joint should be discussed. Such can be accomplished using lag screws, sacral
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