INTRODUCTION: Sacroiliac fixation using iliac screws for highly unstable lumbar spine with an improved fusion rate and clinical results have been reported. On the other hand, there is a possibility of clinical problems related to iliac fixation, including late sacroiliac joint arthritis and pain.
METHODS: Twelve patients were evaluated. Diagnosis was degenerative scoliosis in 5 patients, failed back syndrome in 4 patients, destructive spondyloarthropathy in 2 patients, and Charcot spine in 1 patient. All patients underwent posterolateral fusion surgery using lumbar, S1 and iliac screws. We evaluated the pain scores, bone union, and degeneration of sacroiliac joints by X‐ray imaging and computed tomography before and 3 years after surgery. For evaluation of low back and buttock pain from sacroiliac joints 3 years after surgery, pain relief after lidocaine administration was examined.
RESULTS: Pain scores significantly improved after surgery. All patients showed bone union at final follow up. Degeneration of sacroiliac joints was not seen in the 12 patients 3 years after surgery. Patients showed slight low back and buttock pain 3 years after surgery. However, not all patients showed pain relief from the low back and buttock pain after injection of lidocaine into the sacroiliac joint, indicating that their pain did not originate from sacroiliac joints.
Conclusions: Fusion rate and clinical results were excellent, and degeneration and pain from sacroiliac joints were not seen within 3 years after surgery. We recommend sacroiliac fixation using iliac screws for highly unstable lumbar spine.