SI Joint Fusion
Many patients with chronic low back pain — 15-30% — may have pain caused by dysfunction of the sacroiliac (SI) joint.1-4 The SI joint is also a pain generator in up to 43% of patients with continued or new-onset lower back pain after a lumbar fusion.5
Dr. James Weimar is pleased to offer patients treatment for SI joint dysfunction which utilizes a minimally invasive surgical technique. Sacroiliac joint fusion is clinically proven to be effective in treating SI joint pain.
88% of patients report improved pain, function and quality of life.6
Causes of SI Joint Pain
The sacroiliac joint (SI joint) is located in the pelvis. It links the iliac bones (pelvis) to the sacrum (lowest part of the spine above the tailbone) and is an essential component for energy transfer between the legs and the torso.
Like any other joint in the body, the SI joint can be injured and/or undergo degeneration. When this happens, people can feel pain in their buttocks and sometimes in the lower back, hips and legs. This is especially true while lifting, running, walking or even lying on the affected side.
Symptoms of SI Joint Dysfunction
In addition to pain in the lower back or spine, SI joint dysfunction can produce sciatica-like symptoms, with symptoms present in the buttocks, pelvis, groin, or sometimes in the legs. Chronic SI joint pain symptoms can make it difficult to perform common daily tasks and can affect every aspect of a patient’s life.
People with SI joint dysfunction can even experience impaired function. With symptoms being similar to those of other conditions of the lumbar spine, pelvis and hip, an SI joint examination is crucial to properly diagnosing the origin of the pain.
Do you experience one or more of these symptoms?
- Lower back pain
- Sensation of the low extremity: pain, numbness, tingling, weakness
- Pelvis/buttock pain
- Hip/groin pain
- Feeling of leg instability (buckling, giving way)
- Disturbed sleep patterns due to pain
- Disturbed sitting patterns (unable to sit for long periods, sitting on one side)
- Pain when going from sitting to standing
Making a Diagnosis
A variety of tests performed during physical examination may help reveal the SI joint as the cause of your symptoms. Sometimes X-rays, CT-scan or MRI may be helpful in the diagnosis because they can rule out other common sources of pain — such as your lumbar spine or hip joints. It is also important to remember that other conditions (like a disc problem) can co-exist with SI joint disorders.
The most reliable method for accurately determining whether the SI joint is the cause of your pain is to inject the SI joint with a local anesthetic. This diagnostic injection will be performed under either X-ray or CT guidance to verify the accurate placement of the needle in the SI joint. If your symptoms decrease by at least 50%, it can be concluded that the SI joint is either the source of or a major contributor to your pain. If the level of pain does not change after the injection, it is less likely that the SI joint is the cause of your pain.
Once the SI joint is confirmed as the cause of your symptoms, treatment can begin. Some patients respond well to physical therapy, use of oral medications or injection therapy. These treatments are often performed repetitively, relief of symptoms is often temporary. If non-surgical treatment options have been tried and don’t offer long-term relief, it may be time to consider the minimally invasive iFuse procedure.
Dr. Weimar will assess your condition and discuss treatment options for you.
To discuss whether the SI joint fusion is right for you, call the Abay Neuroscience Center at 316-609-2600 and make an appointment with Dr. James Weimar.
NOTE: Individual results vary. As with any minimally invasive surgical procedure, there are potential risks. It may not be appropriate for all patients and all patients may not benefit.
References:
- Bernard TN, et al. Recognizing specific characteristics of nonspecific low back pain. Clin Orthop Relat Res. 1987;217:266–80.
- Schwarzer AC, et al. The Sacroiliac Joint in Chronic Low Back Pain. Spine. 1995;20:31–7.
- Maigne JY, et al. Results of Sacroiliac Joint Double Block and Value of Sacroiliac Pain Provocation Tests in 54 Patients with Low Back Pain. Spine. 1996;21:1889–92.
- Sembrano JN, et al. How Often is Low Back Pain Not Coming From The Back? Spine. 2009;34:E27–32.
- DePalma MJ, et al. Etiology of Chronic Low Back Pain Patients Having Undergone Lumbar Fusion. Pain Med. 2011;12:732-9.
- Polly DW, et al., and the INSITE Study Group. Two-Year Outcomes from a Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion vs. Non-Surgical Management for Sacroiliac Joint Dysfunction. Int J Spine Surg. 2016;10:Article 28. DOI: 10.14444/3028
- Dengler J, et al. Randomized Trial of Sacroiliac Joint Fusion vs. Conservative Management for Chronic Low Back Pain Attributed to the Sacroiliac Joint. J Bone Joint Surg Am. 2019;101(5):400-11. DOI: 10.2106/JBJS.18.00022.
- Duhon B, Bitan F, Lockstadt H, Kovalsky D, Cher D, Hillen T, on behalf of the SIFI Study Group. Triangular Titanium Implants for Minimally Invasive Sacroiliac Joint Fusion: 2-Year Follow-Up from a Prospective Multicenter Trial. Int J Spine Surg. 2016;10:Article 13. DOI: 10.14444/3013
- Dengler J, et al. on behalf of the INSITE, iMIA and SIFI study groups. Predictors of Outcome in Conservative and Minimally Invasive Surgical Management of Pain Originating from the Sacroiliac Joint – a Pooled Analysis. Spine. 2017;42(21):1664-73. [Epub 2017 Mar 27]. DOI: 10.1097/BRS.0000000000002169
- Whang PG, et al. Long-Term Prospective Clinical and Radiographic Outcomes After Minimally Invasive Lateral Transiliac Sacroiliac Joint Fusion Using Triangular Titanium Implants. Med Devices (Auckl). 2019;12:411-422. DOI: 10.2147/MDER.S219862
- Patel V, et al. Prospective Trial of Sacroiliac Joint Fusion Using 3D-Printed Triangular Titanium Implants: 24-Month Follow-Up. Med Devices (Auckl). 2021;14:211-216. DOI: 10.2147/MDER.S314828