Degenerative changes of the sacroiliac joint after spinal fusion: an evidence-based systematic review

INTRODUCTION: The rate of fusion surgery of the lumbar spine has remarkably increased over the past 30 years. SOURCES OF DATA: We performed a comprehensive search of studies addressing the assessment of sacroiliac joint (SIJ) after lumbar spinal fusion surgery on PubMed, OVID/Medline, Cochrane, CINAHL, Google scholar and Embase. AREAS OF AGREEMENT: The fusion of spinal segments leads to degenerative changes in the mobile segments above or below the fused spine, because of the increase of the stresses imposed on the adjacent levels. AREAS OF CONTROVERSY: There is no consensus about prevalence and potential risk factors contributing to SIJ degenerative changes in patients undergoing fusion surgery. GROWING POINTS: Studies using radiographic evaluation to detect degenerative changes of the SIJ are being performed. AREAS TIMELY FOR DEVELOPING RESEARCH: No definitive estimation about the prevalence of degenerative changes of the SIJ after fusion surgery can be provided. Further studies are required to identify the risk factors involved in post-fusion degenerative changes of the SIJ.