Imagine enduring chronic low back pain, a widespread affliction that affects a significant number of adults around the world. The sacroiliac joint is often implicated as a key source of this pain, creating a critical need for effective treatments. Conventional therapies often fail to provide adequate relief, leading researchers to investigate advanced surgical options, such as minimally invasive sacroiliac joint fusion. This technique is touted to significantly relieve pain, but does it really outperform a placebo?
New insights from a recent study published in the journal eClinicalMedicine in February 2024 offer a detailed examination of the effectiveness of minimally invasive sacroiliac joint fusion versus a sham or sham operation. Led by Dr. Engelke Marie Randers, Dr. Britt Stuge, Professor Lars Nordsletten, Professor Stephan M. Röhrl and Dr. Thomas Kibsgård from the University of Oslo, together with Dr. Elias Diarbakerli from the Karolinska Institutet and the Professor Paul Gerdhem of the Karolinska Institutet. and Uppsala University, the research tested the surgical method against a placebo procedure in a rigorously controlled double-blind study.
Dr. Randers shared his thoughts on the importance of his findings, noting, “Our trial reveals new insights into the impact of minimally invasive sacroiliac joint fusion in the treatment of severe sacroiliac joint pain.” This underlines the pioneering nature of his research and his contribution to medical understanding of a hotly debated topic. The results showed that although there was a reduction in pain scores in both the real surgery group and the sham group, the difference was slight, indicating that the real benefit of the surgical procedure over the placebo could be minimal.
Dr. Randers further discussed the implications of his research, emphasizing: “With these results, we must consider whether a permanent surgical procedure, with its associated risks and complications, is justified when its actual effectiveness is so modest and a placebo effect may occur.” significantly influence outcomes.” This study is crucial as it adds to the accumulating evidence questioning the real benefits of certain surgical interventions compared to placebo effects, particularly given the high expectations and complex nature associated with surgical treatments. The team highlighted the need for continued dialogue within the medical community about whether the risks and complications related to irreversible surgical procedures are justified when their effectiveness could be similar to that of a placebo.
Magazine reference
Engelke Marie Randers, Paul Gerdhem, and colleagues, “The Effect of Minimally Invasive Sacroiliac Joint Fusion Compared to Sham Operation: A Double-Blind, Randomized, Placebo-Controlled Trial,” eClinicalMedicine, 2024. DOI: https://doi.org/10.1016/j.eclinm.2024.102438
About the authors
Engelke Marie Randers He graduated in medicine from the University of Oslo in 2009 and is completing his doctoral thesis on the surgical treatment of the sacroiliac joint. She is a consultant in spinal deformities in the Division of Orthopedic Surgery, Oslo University Hospital, Norway.
Pablo Gerdhem He graduated as a doctor from the Karolinska Institutet, Sweden, in 1993, received his PhD in 2004 from Lund University, Sweden, and became an associate professor there in 2005. From 2019 to 2022 he was an associate professor at the Karolinska Institutet. Since 2023 he is a full professor of Orthopedics at Uppsala University, Sweden.
Britt Stuge She has been a physiotherapist since 1982, completed her PhD at the University of Oslo in 2005 and is a pioneer and renowned researcher in the field of pelvic girdle pain. She currently holds a senior research position at Oslo University Hospital.
Elias Diarbakerli, PhD, is a clinical physical therapist and researcher specializing primarily in spinal disorders. He is currently a senior researcher at Karolinska Institutet and a spine consultant at Karolinska University Hospital, Sweden.
Lars Nordsletten He has had his degree in experimental studies since 1994. His main topics now are total joint replacement and osteoarthritis and he is a professor at the University of Oslo. He is head of clinic R&D and consultant hip surgeon at Oslo University Hospital.
Stephan Maximiliano Herbert Röhrl has a PhD in biomechanics research from Ludwig Maximillian University, Munich, Germany, 1996, followed by clinical research at Umeå University, Sweden, and a PhD in hip arthroplasty completed in 2004. Since 2006 he has been a hip and knee consultant . surgeon who conducts orthopedic research at Oslo University Hospital and holds the position of professor at the University of Oslo since 2023.
Thomas Johan Kibsgård He completed his doctoral thesis on sacroiliac joint fusion and biomechanical movement of the sacroiliac joint in 2014 at the University of Oslo, where since 2016 he has held a position as an associate professor researching sacroiliac joint fusions and spinal deformities. He is also a consultant in spinal deformities at the Division of Orthopedic Surgery at Oslo University Hospital.
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