Sacroiliac Fusions

Lower back or pelvis pain may be caused by a sacroiliac (SI) joint dysfunction, which supports the upper body’s weight when standing. Our doctors at Nacogdoches Medical Partners can help diagnose and treat pain caused by a condition affecting the SI joint. We may also recommend sacroiliac joint fusion if conservative treatment options are insufficient to remove pain.

What Is the Sacroiliac Joint?

The SI joint in the pelvis links the sacrum (the triangular bone at the spine’s base) to the ilium (the large, fan-shaped bone on either side of the pelvis). This joint supports the upper body weight, acts as a shock absorber for the spine and distributes the lower extremities’ rotational force throughout the pelvis and spine, allowing us to walk, run or bend smoothly. The SI joints can also widen to facilitate childbirth in women.

SI joint disorders may be caused by injury, trauma or inflammatory conditions. Symptoms of SI joint dysfunction include lower back pain as well as the following sensations in the lower limb:

• Pain
• Tingling
• Numbness
• Weakness
• Buttock or pelvis pain
• Groin or hip pain
• Leg instability
• Disturbed sleep patterns
• Pain when standing or sitting for long periods
• Pain that worsens when climbing or walking

Consult a doctor if you experience any of the signs above and if the associated pain disrupts your quality of life. A thorough diagnosis must be made to confirm if you have SI dysfunction, as its symptoms may mimic conditions such as hip arthritis, herniated disc sciatica and other conditions that also cause lower back pain.

How Do I Know if I Have SI Joint Dysfunction?

Your doctor will ask for your complete medical history, including finding out if you may have had any injuries, their severity, duration and the affected area. During the exam, your doctor may apply pressure to your hips or sacrum in various positions, which may cause pain to worsen or temporarily alleviate. Imaging tests such as X-ray, magnetic resonance imaging (MRI) or computed tomography (CT) scan may also be recommended. Injection tests may also be done wherein a local anesthetic will be injected into the joint space through the lower back. If the injection reduces your pain significantly, it indicates that the SI joint is likely what causes your pain.

Once confirmed that you have SI joint dysfunction, Nacogdoches Medical Partners will work with you and a team of multi-disciplinary healthcare professionals for an individualized treatment plan. We will recommend non-surgical treatment options first, such as:

• A brief rest period
• Applying heat or ice on the affected area
• Pain medications
• Braces or support
• Manual joint manipulation
• SI joint anesthetic injections

If any of these is not enough to remove pain, your doctor may recommend SI joint fusion.

What Is Sacroiliac (SI) Joint Fusion?

SI joint fusion requires a thorough doctor’s evaluation and consultation to determine whether it’s an appropriate treatment for you. It involves permanently fusing the SI joints using implants and bone grafts. Stabilizing the SI joints this way may help relieve pain and prevent unnecessary movement. This procedure may be performed for various conditions, including trauma, pain, cancer, infection and spinal instability.

A spine or orthopedic surgeon can perform SI joint fusion surgery using an open or minimally invasive approach. The patient is put to sleep using general anesthesia before an SI procedure. With an open SI joint fusion, the surgeon makes an incision in the lower back to access the SI joint. A block of bone will be removed to reach the sacrum’s surface, which is covered with cartilage. The surgeon removes this cartilage and replaces the block of bone. Screws and plates will then be used to secure the bone in place and stabilize the SI joint.

For minimally invasive SI joint fusion, the surgeon makes a small incision on the buttock’s side and accesses the ilium by cutting through the gluteal muscles. Special tools are used to guide the implants toward the sacrum and implant them using pins and screws. The surgeon uses saline to clean the surgical site to remove extra bits of tissue or bone before using sutures to close the wound.

It will take time for the bones to fuse and heal after surgery. Pain and other discomfort can be expected but usually alleviate within a few weeks. The entire recovery process for sacroiliac fusion can take up to six months. Always tell your doctor if you experience concerning symptoms while you’re recovering.

What Is the Success Rate of SI Joint Fusion?

A study published in the Journal of Neurosurgery revealed that 54% of patients reported excellent satisfaction with reduced pain, improved function and quality of life after undergoing open SI joint fusion surgery. On the other hand, an average of 84% of patients who underwent minimally invasive SI fusion reported excellent outcomes. The reoperation rate after open surgery averaged 15%, while it was 6% for minimally invasive.

Does SI Joint Fusion Limit Mobility?

SI joint fusion can limit your mobility, but it depends on your overall health, fitness level, age and pre-existing conditions affecting your spine. As such, your doctor may recommend physical therapy and rehabilitation to help you optimize your mobility after surgery. Our spine doctors at Nacogdoches Medical Partners will discuss the procedure’s potential outcomes and limitations, how it can help your condition and what to expect post-surgery.

Devoted to Excellence in Patient Care

Nacogdoches Medical Partners strives to help improve the quality of life of our patients by assisting them to live free of bone and joint pain. Contact us today to get checked and assessed for possible SI fusion treatment.