Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Helena Brisby, University of Gothenburg, Sweden
- Second opponent: Associate Professor Ivar Rossvoll, NTNU: Norwegian University of Science and Technology,
- Third member and chair of the evaluation committee: Professor II Espen A. Haavardsholm, University of Oslo
Chair of the Defence
Associate Professor Frede Frihagen, University of Oslo
Principal Supervisor
Senior Researcher Britt Stuge, Oslo University Hospital
Summary
Treating sacroiliac joint pain can be demanding and challenging. Despite there being little motion in the sacroiliac joints, fusing the joints surgically has the potential to reduce pain and improve physical function in some patients.
The main aim of the thesis was to evaluate the effect of minimally invasive sacroiliac joint fusion in reducing pain and increasing physical function. To achieve this a double-blind randomized sham surgery-controlled trial was performed to examine effect of the operation. Patient reported treatment outcomes from daily practice were evaluated through a registry-based cohort trial. Finally, the implants used for fusion were evaluated to see whether their characteristics can impact on the observed effectiveness of surgery.
The thesis could not show sacroiliac joint fusion to be superior to sham surgery. There was a large placebo effect, and although there was little additive effect of surgical fusion there seemed to be selected patients who benefited from the procedure. The observed effect of surgery was smaller than reported in previous literature. Many patients were satisfied having undergone surgery; however, others reported to have no gain or worsening of symptoms. Failure of implant osseointegration could potentially contribute to the lack of surgical effect, however, our studies found that in some of the patients with poor results after surgery the implants can show full bony ingrowth. Other unknown factors may therefore also impact on the observed result of surgery.
Based on the existing criteria and diagnostics for selecting patients to sacroiliac joint fusion the effect of surgery is found to be inconclusive by the research methods used in this thesis. With advancements in diagnostics and selection criteria’s the observed effect after surgery may improve, however this needs to be investigated with future research.
Additional information
Contact the research support staff.