Sacroiliac fusion using ilioilial fixator in managing refractory cases: A retrospective case series study

Objectives: To assess clinical and radiological results of using an ilioilial fixator for sacroiliac (SI) fusion in refractory sacroiliitis. Methods: Data from 20 cases with refractory sacroiliitis managed with an ilioilial fixator and fusion using a mini-open approach were retrospectively collected. The mean age was 48.2 ± 9.4 years. Functional evaluation included visual analog scale (VAS) and Oswestry Disability Index (ODI) scores. Fusion rates, time to fusion, and complications were assessed. Results: Mean follow-up period was 24.5 months. Mean operative time was 68.5 min, and mean intraoperative blood loss was 125.5 mL. VAS and ODI scores improved significantly from a pre-operative mean of 8.5% and 68%, respectively, to a post-operative mean of 2.2 and 24%, respectively ( p < 0.001). Fusion rate was 85% (17 cases), with a mean time to fusion of 6 months. Only 3 cases had minor complications (mild superficial wound infection, asymptomatic hardware prominence). No revision surgeries were done. Conclusion: The ilioilial fixator with a mini-open approach is a safe and effective technique for SI fusion in refractory sacroiliitis with functional and clinical improvement, and a fusion rate comparable to reported techniques in the literature.