Sacroiliac Joint Surgery

Dr. Stevenson is trained in the latest minimally invasive surgical (MIS) techniques, including use of the iFuse Implant System® from SI-BONE®, Inc., a medical device company pioneering MIS sacroiliac (SI) joint treatment. The iFuse System is intended for sacroiliac joint fusion for conditions including sacroiliac joint disruptions and degenerative sacroiliitis. As with all surgical procedures and permanent implants, there are risks and considerations associated with surgery and use of the iFuse Implant.

The SI joint is a significant cause of low back pain. Publications and clinical research show the SI joint as a pain generator in up to 25% of low back pain and up to 43% of post-lumbar and lumbosacral fusion patients.1,2

 

Sacroiliac Joint (SI Joint) Anatomy

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). It is an essential component for shock absorption to prevent impact forces during walking from reaching the spine.

 

Do you have SI Joint Problems?

The SI joint is a significant cause of low back pain. Publications and clinical research show the SI joint as a pain generator in up to 25% of low back pain and up to 43% of post-lumbar and lumbosacral fusion patients.1,2

Like any other joint in the body, the SI joint can become damaged. SI joint pain can be due to a number of conditions, including degeneration, disruption, inflammatory conditions such as ankylosing spondylitis, tumor, infection or other problems. When this happens, people can feel pain in their upper leg(s), buttock and sometimes even higher on the skeleton. This is especially true with sitting, lifting, running, walking or even sleeping on the involved side.

It is important to note that on occasion, patients who have not had relief from lumbar or lumbosacral spine surgery may actually have had other co-existing problems. This could include the SI joint, the hip, and the spine separately or any combination of these three potential pain generators.

 

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 of SI joint-related problems.

The most relied upon method to accurately determine whether the SI joint is the cause of your low back pain symptoms is to inject the SI joint with a local anesthetic. The injection will be delivered with either X-ray or CT guidance to verify accurate placement of the needle in the SI joint. If your symptoms are decreased by at least 75%, it can be concluded that the SI joint is either the source of or a major contributor to your low back pain. If the level of pain does not change after SI joint injection, it is less likely that the SI joint is the cause of your low back pain.

 

Treatment Options

Once the SI joint is confirmed as the cause of your symptoms, treatment can begin. Some patients respond to physical therapy, chiropractic manipulations, use of oral medications, or injection therapy. Intermittent use of a pelvic belt may provide symptomatic relief as well. These treatments are performed repetitively, and frequently symptom improvement using these therapies is temporary. At this point, you and your surgeon may consider other options, including minimally invasive surgery.

 

SI Joint Fusion with the iFuse Implant System®

The iFuse Implant System is designed to provide stabilization and fusion for the SI joint. This is accomplished by inserting small titanium implants across the sacroiliac joint to maximize post-surgical stability and weight bearing capacity. The procedure is done through a small incision and takes about an hour.

 




 

 

**The iFuse Implant System is a minimally invasive surgical option for SI joint conditions, including sacroiliac joint disruptions and degenerative sacroiliitis. As with all surgical procedures and permanent implants, there are risks and considerations associated with surgery and use of the iFuse Implant. You should discuss these risks and considerations with your physician before deciding if this treatment option is right for you.

1. Sembrano, Jonathan N, and David W Polly. “How Often Is Low Back Pain Not Coming from the Back?” Spine 34, no. 1 (January 1, 2009): E27–32.
2. DePalma, Michael J, Jessica M Ketchum, and Thomas R Saullo. “Etiology of Chronic Low Back Pain in Patients Having Undergone
Lumbar Fusion.” Pain Medicine (Malden, Mass.) (April 11, 2011). http://www.ncbi.nlm.nih.gov/pubmed/21481166.