Zyga Technology, Inc. has released 12-month fusion and clinical results for patients receiving Slmmetry Sacroiliac (SI) Joint Fusion with decortication. The results of the prospective, multicenter study were recently presented at the 2016 Society for Minimally Invasive Spine Surgery (SMISS) Annual Meeting by William Cross, M.D., an orthopedic trauma surgeon at the Mayo Clinic in Rochester, Minnesota.
Zyga Technology: Positive Results for SImmetry

“Minimally Invasive SI joint fusion has been established as an effective treatment for certain patients suffering from SI joint disorders, but many technologies available today don’t follow the accepted orthopedic principles that lead to successful long-term fusion, ” said Dr. Cross, the lead author and presenter at the SMISS scientific meeting, in the October 17, 2016 news release. “For me, it’s common sense that SI joint fusion should include decortication and bone grafting to achieve long-term success. The results of this study provide compelling evidence that decortication and bone grafting may contribute to earlier fusion, and that the procedure provides significant pain relief at one year post-op.”
According to the news release, “…19 patients at three institutions underwent a CT scan 12 and 24 months after receiving minimally invasive SI joint fusion with decortication and bone grafting. CT images were reviewed by a non-biased, independent radiology core laboratory to assess fusion in relation to the joint and the area of decortication. At 12 months, fusion was reported in 74% of patients, and back pain decreased from 7.9 to 2.2 (72%). Of patients in whom fusion was reported, 86% showed fusion in the area of decortication. Freedom from device- or procedure-related adverse events through 12 months was 100%. 24-month results for the study are expected in early 2017.”
Dr. Cross told OTW, “One of the most interesting findings in this study is the durable nature of pain relief in the vast majority of patients at one year. Sustained improvements of over five points in the Numerical Pain score at one year is outstanding. It is clear that our beliefs in the fundamentals of joint arthrodesis (joint decortication, bone grafting, and stabilization) are sound and provide most patients with considerable and durable pain relief.”
“Most orthopedic surgeons should recognize that when principles of arthrodesis are followed, predictable fusion and pain relief can be anticipated in appropriately selected patients. Our data really speaks for itself and provides clear evidence on the merits of joint decortication and bone grafting.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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