Patient-Specific 3D Virtual Surgical Planning Using Simulated Fluoroscopic Images to Improve Sacroiliac Joint Fusion

Nick Kampkuiper*, Jorm Nellensteijn, Edsko Hekman, Gabriëlle Tuijthof, Steven Lankheet, Maaike Koenrades, Femke Schröder

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Sacroiliac (SI) joint dysfunction can lead to debilitating pain but can be treated with minimally invasive sacroiliac joint fusion (SIJF). This treatment is commonly performed using 2D fluoroscopic guidance. This makes placing the implants without damaging surrounding neural structures challenging. Virtual surgical planning (VSP) using simulated fluoroscopic images may improve intraoperative guidance. This article describes a workflow with VSP in SIJF using simulated fluoroscopic images and evaluates achieved implant placement accuracy. Ten interventions were performed on 10 patients by the same surgeon, resulting in a total of 30 implants; the median age was 39 years, and all patients were female. The overall mean implant placement accuracy was 4.9 ± 1.26 mm and 4.0 ± 1.44°. There were no malpositioning complications. VSP helped the surgeon understand the anatomy and determine the optimal position and length of the implants. The planned positions of the implants could be reproduced in surgery with what appears to be a clinically acceptable level of accuracy.

Original languageEnglish
Pages (from-to)511-522
Number of pages12
Issue number4
Early online date1 Nov 2023
Publication statusPublished - Dec 2023


  • Implant placement accuracy
  • Minimally invasive surgery
  • Patient-specific modeling
  • Sacroiliac joint dysfunction
  • Sacroiliac joint fusion
  • Simulated fluoroscopic images
  • Virtual surgical planning


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