Subject: Draft Key Questions for Health Technology Assessment (HTA) Program
Review of Sacroiliac Joint Fusion
Dear Mr. Morse:
On behalf of the American Association of Neurological Surgeons (AANS), Congress of Neurological
Surgeons (CNS), AANS/CNS Joint Section on Disorders of Spine and Peripheral Nerves (DSPN) and
Washington State Association of Neurological Surgeons (WSANS), we appreciate the opportunity to
provide feedback on the draft key questions for evidence review for sacroiliac (SI) joint fusion. In our
estimation, the draft questions are generally reasonable and appropriate for the evaluation of efficacy,
safety and cost of SI joint fusion procedures. However, we offer the comments below regarding some of
the specifics proposed to assess the procedure.
Efficacy Questions
Efficacy question 1 (EQ 1). What is the effectiveness and comparative effectiveness of sacroiliac
joint fusion surgery on health outcomes?
Question EQ 1 refers to effectiveness of SI joint fusion on health outcomes. Outcomes include pain,
function, quality of life (QOL), patient satisfaction, opioid use and return to work. These outcome
measures are all used in the available randomized controlled trials (RCTs) for SI joint fusion and
represent readily quantifiable outcome measures. We feel these are appropriate.
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