RECOVERY from Sacroiliac Joint Dysfunction

Patient Support For Low Back Pain

SI Surgery

Written By: mysijd

SACROILIAC JOINT STABALIZATION THROUGH SURGICAL TREATMENT:

***CONTINUED HYPERMOBILITY AFTER CONSERVATIVE THERAPY METHODS HAVE BEEN APPLIED MAY INDICATE THE NEED FOR A SURGICAL SACROILIAC JOINT FIXATION CONSULTATION…
SURGICAL TREATMENTS:
I. Sacroiliac Joint Screw Fixation
II. Sacroiliac Joint Fusion
NOTE: ESSENTIAL TO THE SUCCESSFUL OUTCOME OF SI SURGERY IS TWO THINGS:
1. TO ALIGN THE SI JOINTS AT THE TIME OF SURGERY JUST PRIOR TO FIXATION. THUS, ASSURING THE SI JOINT IS NOT PERMANENTLY FIXATED IN A SUBLUXATED (PARTIALLY DISLOCATED) POSITION!
2. HAVE A GOOD POST-OP THERAPY PROGRAM AIMED AT PROGRESSIVELY RETRAINING THE MUSCLES WHILE ALSO ADDRESSING THE SOFT TISSUES WHICH HAVE BEEN AFFECTED.

SI FIXATION with Implants: to stabilize the sacroiliac joint, cannulated screws will be placed through the ilium and sacrum. The cannulated screws that your physician will use for stabilization are approved by the U.S. Food and Drug Administration (FDA) for fixation of fractures of large bones. It is inferred from this that they are solid enough for sacroiliac stabilization for which they are commonly used.

SI FIXATION LEADING TO FUSION with ifuse Implants:>iFUSE Implant System by SI-BONE: TRIANGULAR SHAPED IMPLANT RODS-> are titanium devices which are coated with a porous plasma spray. It is an SI Fixation procedure which leads to SI Fusion.

SI (Traditional, open back) FUSION: between the sacrum and the ilium fusion may also be necessary. This is done by scraping the bone on both sides and placing a graft taken from the iliac crest at the surgical site between the two sides. Artificial graft can also be used. If your physician determines that a fusion is not necessary in your case, the joint will be fixed in place using only the screws.

PIRIFORMIS SURGERY: often inflamed or swollen as a result of SIJD. Among other symptoms, the Piriformis Muscle can irritate the sciatic nerve causing radiating leg pain and butt pain.

CRITERIA FOR SURGICAL STABALIZATION OF THE SACROILIAC JOINTS commonly include the following (by Alan Lippitt, MD):
1. Pain must be disabling.
2. Pain must be localized to the SIJ and not relieved by conservative modalities.
3. Pain should be relieved on a transient basis by a fluoroscopically controlled SIJ block.
4. Other causes of lumbopelvic pain such as herniated nucleus pulposus, facet arthropathy, trapped nerve root, spinal stenosis, hip disorders, etc. should be ruled out.
5. Associated conditions must be treated before, in conjunction with, or after treating the SIJ dysfunction.

GLOSSERY OF TERMS commonly associated with Sacroiliac Surgeries:

>SI FIXATION: SCREW IMPLANTS->the placement of cannulated titanium screws screws across reduced (properly positioned) Sacroiliac Joints

>SI FUSION: TRADITIONAL FUSION-> sacroiliac joint fusion involves open surgery to access the SI joint, bone removal, and adding bone graft to help the joint heal.
*note: for traditional SI Fusion to be succesful, it should be combined with SI Fixation to ensure joint stabalization during bone growth.

>iFUSE Implant System by SI-BONE: TRIANGULAR SHAPED IMPLANT RODS-> are titanium devices which are coated with a porous plasma spray. It is an SI Fixation procedure which leads to SI Fusion.

>PIRIFORMIS RELEASE: the piriformis muscle goes from the sacrum to the hip joints where it inserts. Piriformis surgery typically involves cutting the tendon of the muscle at its site of insertion.

>SACROILIAC JOINT ALIGNMENT: it is believed to be an important procedure to have this done on the operating table just prior to the Sacroiliac Surgery. It is a MANUAL technique to ‘reposition’and align the SI Joints. The pelvic complex is brought back in it anatomically right position, before being securing it with harware.
>”bilateral”: both sides
>”unilateral”: one side

11 Comments

  1. Brenda Conley says:

    I have been struggling with si problems for over 1 year. I have had a pen infusion put in already . This is not working very well. I am going to have another surgery on may 16th this year. a screw and fusion will be performed. iI have a great DR. my body is just not responding correctly to the last surgery i had. thanks for listening.

  2. Amysijd says:

    Brenda what is a pen infusion?

  3. Stan Holoman says:

    It’s actually a great and helpful piece of information. I am happy that you shared this helpful information with us. Please stay us up to date like this. Thanks for sharing.

  4. lisa says:

    I have had SI joint pain for about 2 years now. I’ve had 3 injections and 1 ablation. None of which have worked. Im taking 350mg tramadol a day and about 1.5mg klonipin a day along with celexa. supposidly celexa works with the tramadol to relieve pain. I am at my wits end with this. Im constantly in pain and have been doing research on the screw implants. I think this is my last hope. my life has changed drastically since Ive been debilitated with pain. I am a fraction of the woman I used to be and dont know what else to do as my life as is now is unacceptable to me. I would appreciate any comments or feedback on anyone with simular situation. please!

  5. lisa bowden says:

    dealing w/ SI joint isues for over 2yrs. 3 injections and 1 ablation to no avail. surgery is next. please…comments, suggestions.

  6. Amysijd says:

    Lisa, have you tried working with a PT that knows about SI issues?
    If your SI joint injections did not give you relief there is a great chance that the surgery will not either. Your pain generator could be something else like hip or spine. I suggest your next step prior to surgery is working with surgeon, PT and pain management Dr to try and figure out what is going on BEFORE you cut.

    This surgery is NOT a quick fix, nor is it always indicated… sometimes it’s just a down right bad idea, so I STRONGLY encourage you to work with Dr’s that will help you figure out where your pain is coming from and how your spine and hips are working as well as your SI joint.

    best of luck, and please keep reading around the site to educate yourself as much as you can.

  7. Alysia says:

    Lisa,
    I feel exactly the same way you do. I have had several problems diagnosed by specialists, from It band tightness causing bursitis of hip, and having the Berra surgically removed, and IT band surgically released. Soon after, pain traveled down my left to my foot, causing excruciating pain. Nerve conduction study showed pinched scatic nerve, pinched by piriformis muscle. All of the above conditions were correct, but all are being caused by a dysfunctional SI joint, bilaterally. Right side is tilted extremely forward, pulling on IT band, and piriformis muscle. It took so long and so much fighting on my part to get this diagnosis determined, it is now an extreme case, causing 24/7 acute pain. I’m also considering screw implants, and go next Thursday to be evaluated. I think that people mean well, but if they have never felt this pain, they have no frame of reference.

  8. Rheannon says:

    I had my left SI fixated 4 years ago and am scheduled for the right to be done on June 13. With the constant instability of my SI on the left the first time around, surgery was a blessing, and I am eagerly awaiting the second.

    Recovery wasn’t as horrible as I expected the first time, and I was actually back to work (light-duty) after a week.

  9. Amysijd says:

    After a week, that’s wonderful and amazing!

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