Primary Sacroiliac Fusion Versus Fusion to the Sacrum for Degenerative Disease of the Lumbar Spine

Primary Sacroiliac Fusion Versus Fusion to the Sacrum for Degenerative Disease of the Lumbar Spine

To prove that the use of additional S2alar-iliac screws for pure lumbar fusions due to degenerative lumbar disease provides superior outcome compared to the standard procedure of fusion to S1.

Patients with symptomatic degenerative spine disease with or without spinal stenosis undergoing lumbosacral fusion to S1. Pedicle screws for posterior Instrumentation and fusion of the lumbar spine plus intervertebral fusion L5/S1 (anterior lumbar inter body fusion (ALIF), transforaminal lumbar inter body fusion (TLIF), or posterior lumbar inter body fusion (PLIF)) with

1. Caudal end of the instrumentation at S1
2. Caudal end of the instrumentation at iliac bone via S2alar-iliac screws

Stratification of both groups by:

• Number of instrumented levels
• Sagittal balance (Roussouly type 1+2 vs. 3+4)

Prospective, randomized, controlled, rater-blinded multicentric interventional study with two parallel groups

Inclusion Criteria:

• Patients with symptomatic degenerative spine disease with or without spinal stenosis undergoing lumbosacral fusion to S1
• Lumbar or thoracolumbar Instrumentation
• Planned ventral intervertebral fusion (ALIF, TLIF, PLIF) in L5/S1
• Age ≥ 18 years

Exclusion Criteria:

• Scoliosis >20°

• Chronic steroid usage

• Significant co-morbidity influencing the surgical success:

  • Osteoporosis
  • Rheumatoid arthritis
  • Mental illness/dementia