Our Summary

Sacroiliac (SI) joint dysfunction, which can cause pain and disability, has traditionally been treated with open surgery. However, in the last decade, minimally invasive surgical (MIS) techniques have become more popular, and new devices for these procedures have been approved. Not only surgeons, but also other healthcare professionals are performing these MIS procedures for SI problems.

This study looked at how many SI joint fusion surgeries were performed, who performed them, and how much was charged and reimbursed by Medicare from 2015 to 2020. It found that out of almost 13,000 SI joint surgeries, the majority (76.5%) were minimally invasive. More than half of these MIS procedures were performed by non-surgeons, while most of the open surgeries were done by spine surgeons. The number of MIS procedures has grown rapidly, and more of these procedures are being done in outpatient centers.

The rates at which Medicare reimbursed the billed charges increased over time, and was similar for spine surgeons and non-surgeons performing MIS procedures. The study concludes that the growth in MIS procedures for SI problems can be attributed largely to non-surgeons, and that further research is needed to understand how these trends affect patient outcomes and costs.

FAQs

  1. What has been the most common surgical method for SI joint fusion surgeries between 2015 and 2020?
  2. Who has been performing most of the minimally invasive surgical procedures for SI joint problems?
  3. How has the rate of Medicare reimbursement for SI joint fusion surgeries changed over the observed timeframe?

Doctor’s Tip

A helpful tip a doctor might tell a patient about joint fusion is to consider minimally invasive surgical techniques, as they have become more popular and can result in quicker recovery times and less scarring compared to traditional open surgery. It’s important to discuss all options with your healthcare provider to determine the best treatment plan for your specific condition.

Suitable For

Patients who are typically recommended joint fusion are those with chronic SI joint dysfunction that has not responded to conservative treatments such as physical therapy, medications, and injections. Patients who have significant pain and disability related to their SI joint dysfunction may be candidates for joint fusion surgery. This procedure is usually considered after other treatment options have been exhausted and the patient’s quality of life is significantly impacted by their SI joint dysfunction.

Timeline

Before joint fusion, a patient may experience chronic pain and disability due to sacroiliac joint dysfunction. Traditional treatment methods may not provide long-term relief, leading to the need for surgery. Minimally invasive surgical techniques have become more popular in recent years, offering a less invasive option for patients.

After joint fusion surgery, patients typically experience a period of recovery and rehabilitation. This may involve physical therapy to regain strength and mobility in the affected joint. Over time, patients should experience a reduction in pain and an improvement in overall function and quality of life. Medicare reimbursement rates for these procedures have increased over time, and the trend towards minimally invasive procedures is expected to continue. Further research is needed to fully understand the impact of these trends on patient outcomes and healthcare costs.

What to Ask Your Doctor

  1. What is the success rate of minimally invasive SI joint fusion surgery compared to traditional open surgery?
  2. What are the potential risks and complications associated with SI joint fusion surgery?
  3. How long is the recovery time for SI joint fusion surgery, and what can I expect in terms of pain management and rehabilitation?
  4. Are there any alternative treatments or therapies for SI joint dysfunction that I should consider before opting for surgery?
  5. What qualifications and experience do you have in performing SI joint fusion surgery, and how many of these procedures have you performed?
  6. Will I need to follow any special precautions or restrictions after the surgery, and how soon can I return to normal activities?
  7. What is the typical cost of SI joint fusion surgery, and will my insurance cover it?
  8. Are there any factors that may affect my candidacy for SI joint fusion surgery, such as age, weight, or other health conditions?
  9. How long can I expect the results of the surgery to last, and are there any potential long-term implications or risks to consider?
  10. Can you provide me with any patient testimonials or references from others who have undergone SI joint fusion surgery with you?

Reference

Authors: Hersh AM, Jimenez AE, Pellot KI, Gong JH, Jiang K, Khalifeh JM, Ahmed AK, Raad M, Veeravagu A, Ratliff JK, Jain A, Lubelski D, Bydon A, Witham TF, Theodore N, Azad TD. Journal: Neurosurgery. 2023 Dec 1;93(6):1244-1250. doi: 10.1227/neu.0000000000002564. Epub 2023 Jun 12. PMID: 37306413