Background
Sacroiliac joint (SIJ) fusion is a surgical intervention for SIJ dysfunction in patients who have failed conservative measures. This approach may also be beneficial for patients with Ehlers-Danlos syndrome (EDS) suffering from SIJ dysfunction. The purpose of this study is to compile existing literature on patient outcomes following SIJ fusion to treat lowback pain secondary to SIJ dysfunction in EDS, and to present a retrospective case series assessing the efficacy of this intervention.
Methods
Studies from the past 10 years were included provided data on SIJ fusion for the treatment of lower back pain in EDS patients was presented. Additionally, a case series of EDS patients who underwent SIJ fusion (n=17) between July 2019 and May 2025 by a single surgeon was analysed retrospectively. The data analysed included demographics, procedural details, clinical outcomes and complication rates.
Results
One study, met the inclusion criteria. The study reported a ‘patient satisfaction score’ in 16 patients which overall suggested positive outcomes associated with the surgery. Reported complications include nerve impingement due to implant malpositioning in one patient, and a lack of pain relief in another. Our case series looked at these outcomes independently using validated scales and found an improvement in all of them post-operatively compared to baseline data. Postoperative improvement was observed, with reductions in VAS back pain and VAS leg pain by 2.83 and 2.17. ODI decreased by 5.55, RMDQ improved by 3.35, and EQ-5D increased by 8.57.
Conclusion
There is a paucity in the effectiveness evidence of SIJ fusion for treating lower back pain in EDS patients, necessitating further studies. The limited data that has been evaluated from the literature review and case series suggests that SIJ fusion is associated with positive pain, functional, and quality of life outcomes for EDS patients with lower back pain.