Since 2009 many new SIJ fusion systems were presented which raise huge expectations for the medical device industry and for patients. SIMEG is not recommending or prefering any technique, efficacy needs to be approved by appropriate clinical studies (see our study page). The development of an international register to collect the product features is discussed. Basically there are four SIJ fusion principles:
1. Posterolateral approach: Mechanical primary stabilization utilizing one or more percutanous, transgluteal screws or dowels transfixing the ilial and sacral bone for secondary arthrodesis.
2. Posterior approach: Transfixing dorsolateral technique like (1) with or without additional bonegrafting.
3. Posteromedial: Distraction of the joint space and realignment of the dislocated articular surfaces. Primary fusion with temporary mechanical immobilisation in mini-open technique via a posterior midline approach.
4. Posterior inferior: Expansion of the joint space, primary fusion supported by a cage type implantat inserted via a posterior inferior approach.
Non-surgical treatment is mandadory prior to considering surgery. A consensus about the definition 'end of therapy' should be found.
Hip-prosthesis, spinal implants, kyphoplasty: all developments started from emergency (trauma/cancer) indications with few case numbers. Degenerative (orthopedic) indications represent a much higher number of cases, which attracts medical device manufacturers.