SI Joint Fusion
What is Sacroiliac Joint Disease
The sacroiliac joint is in the low back where the spine meets the pelvis. Sacroiliac joint pain is discomfort in this area. This pain is a symptom that may come from a number of conditions or diseases.
What are the Causes of Sacroiliac Joint Disease?
- Twisting, bending, or moving in a way that triggers sacroiliac joint pain
- Infection of the joint
- Osteoarthritis of the joint (more common in older adults)
- Trauma, such as auto accidents
- Stress Fracture in athletes
- Inflammation of the joint, such as with Ankylosing Spondylitis
- EXAMPLE-MVA SCENARIO: The foot gets locked down against the floorboard during the accident at the time of impact. Therefore the impact caused force imparted from the seat into her pelvis and then down the femur, tibia, into the calcaneus and foot into the floor and then an equal and opposite force from the floor in the reverse direction through the hip into the pelvis through the sacroiliac joint as the sacrum, which is the keystone of the pelvis. This is consistent with symptoms and signs of posttraumatic sacroiliitis.
- So even patients with negative MRI findings, that continue with pain, should be worked up for the SI joint. Provocative testing and diagnostic injections should be performed.
- pain to the left or right of the lower back.
- pain may radiate out into the buttocks and low back and will often radiate to the front into the groin.
- Occasionally the pain in the lower limb which can be mistaken for sciatica.
Other symptoms: difficulty turning over in bed, struggling to put on shoes and socks, pain in your legs while getting in and out of the car, stiffness in the lower back when getting up after sitting for long periods , getting up from bed in the morning.
Anatomy of the Sacroiliac Joint
There are two sacroiliac (SI) joints. They are in the very low back (buttocks area). There is one joint on either side of the pelvis. The SI joints link the sacrum to the ilium. Located between the sacrum (tailbone) and ilium (hip bone) in the pelvis, the sacroiliac (SI) joint (Fig. above and below) is a common frequently overlooked source of low back pain. SI joint pain is not specific to any particular age group, occupation, or sporting activity.
Establishing the diagnosis
Diagnosing SI joint dysfunction can be difficult because the symptoms and physical findings of this condition are also seen in other well-recognized causes of low back pain (including a herniated, or slipped, disc). Your physician can diagnose SI joint dysfunction by carefully reviewing your clinical history and performing a thorough physical examination. Plain x-rays, CT, and MRI are not usually helpful in establishing the SI joint as a source of low back pain, other than ruling out back pain that may be caused by a disc herniation, pinched nerve, inflammation, or infection.
The most widely used method to determine the cause of SI joint pain is to inject the SI joint with painkillers. Your doctor will deliver the injection with either X-ray guidance or CT guidance to ensure that the needle is accurately placed in the SI joint. If, following the injection, your pain is decreased by more than 75%, then it can be concluded that the SI joint is either the source, or a major contributor, to your low back pain. If the level of pain does not change after the injection, it is unlikely that the SI joint is the cause of your low back pain.
At Florida Spine and Joint Institute our Surgeon specialize in Same Day surgery. Our spine surgeons are the most experienced and best trained surgeons to relieve the pain from sacroiliac joint disease. We offer the most effective and widest variety of conservative and surgical sacroiliac joint disease treatments available to get you back home the same day and back to your life. Florida Spine and Joint Institute specializes in minimally invasive treatments for sacroiliac joint disease surgeries, using the latest cutting edge technologies.
Minimally Invasive Procedure
Also called laparoscopic surgery — for several conditions. In minimally invasive procedures, your doctor makes one or more incisions, each about a half-inch long, to insert a tube. The number of incisions depends on the type of surgery. The tube or tubes let the doctor slip in tiny video cameras and specially designed surgical instruments to perform the procedure.
When you have minimally invasive surgery, you’re likely to lose less blood and have less postoperative pain, fewer and smaller scars, and a faster recovery than you would after open surgery. Depending on your condition, you may need only a short hospital stay.
For some conditions, your doctor may recommend robotic surgery. That technology gives your doctor great precision, flexibility and control by providing a magnified, 3-D view of the surgical site.
Same Day Surgery (SDS) is available for surgical procedures that generally do not require an overnight stay in the hospital. This service is designed to save the patient the expense and inconvenience of an overnight hospital stay. Following the procedure, the patient’s condition is monitored in the SDS unit. Some procedures, however, may require patients to be admitted to a hospital room following surgery.