Health technology reviews

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Sacroiliac joint fusion

Status: Decision complete.

View findings and decision


Sacroiliac joint fusion is a surgical treatment sometimes used to address pain that may be originating from the joint between bones in the spine and hip (sacrum and ilium). The sacroiliac joint (SIJ) is a diarthrodial joint with two surfaces and a fibrous capsule containing synovial fluid. Numerous ligaments support the joint and provide it with strength, but also limit its mobility.

SIJ pain and dysfunction is thought to be the primary source of pain for between 10 to 30 percent of cases of mechanical low back pain. Surgery, specifically SIJ fusion, is typically reserved for persons who fail conservative and less invasive treatments. Fusion of the SIJ can be performed as an open procedure, or since the late 1990's, as a minimally-invasive procedure using proprietary surgical systems consisting of two to three specialized implants or screws inserted directly into the SIJ through small incisions under imaging guidance.

Policy context

The Washington Health Technology Assessment program (HTA) selected Sacroiliac joint fusion as a topic for assessment because of high concerns for safety, efficacy and cost.

Primary criteria ranking

  • Safety = High
  • Efficacy = High
  • Cost  = High

Assessment timeline

  • Draft key questions published: June 20, 2018

  • Public comment period:  June 21, to July 5, 2018

  • Final key questions published: July 20, 2018

  • Draft report published: October 10, 2018

  • Public comment period:  October 10, to November 9, 2018

  • Final report published:  December 7, 2018

  • HTCC public meeting: January 18, 2019