Living with chronic lower back pain can have a profound impact on not just your physical well-being, but your overall quality of life. Many people suffer from back pain due to dysfunction in the sacroiliac (SI) joint, which connects the bottom of the spine (sacrum) to the pelvis (ilium). These two joints, one on each side act as a shock absorber for the spine and play a crucial role in stability and weight bearing ability, transferring pressure from the lower back to the legs. The SI joint can be damaged by traumatic injury, a degenerative condition, or tissue loosening from things such as connective tissue disorders and pregnancy. Patients with SI dysfunction will feel pain in the low back, especially when walking, standing up from a seated position, or lifting. Other symptoms can include numbness or tingling in the lower extremities; pain in the pelvis, hip, or groin; pain radiating down the legs; or buckling in the legs.
Diagnosing SI Dysfunction
Because low back pain can be a symptom of other conditions like sciatica, diagnosis is usually done with a physical exam, followed by an injection that will temporarily block the pain if it’s originating in the sacroiliac joint. In some cases, the pain can be managed with anti-inflammatory medications, physical therapy, or steroid injections, but for patients who haven’t responded to those treatments there is a minimally invasive procedure called SI Fusion that may offer sustained relief.
What is the SI Fusion Procedure?
SI Fusion, short for sacroiliac joint fusion, is a minimally invasive procedure in which the surgeon inserts an implant into the SI joint space. Guided by real-time imaging, a small incision is made and the implant is fixed in place, fusing the sacrum to the ilium in order to limit movement. This fusion, by restricting excessive motion in the SI joint, restores stability and alleviates pain.
What Does the Recovery From SI Fusion Involve?
Because the procedure is minimally invasive, the risk of complications is low and recovery times are quicker than with traditional open surgery. Patients can expect to be mobile immediately after the procedure, and most experience rapid pain relief. Post-operative physical therapy may be recommended to restore function in the joint and aid recovery.
Below, a Q&A about SI Fusion with pain management specialist Dr. Lehn:
How does this procedure benefit your patients?
15-30% of low back pain comes from the SI joint. The SI joint can be a difficult pain to treat as many times PT, medications, and injections only provide temporary relief.
Who is a good candidate for an SI fusion?
If a patient has 90% relief of pain from a SI injection and the pain keeps returning despite exercise, medications, and repeated injections, then they can be considered for SI fusion.
Where do you perform this procedure?
The procedure is performed in the operating room but is done with minimal sedation, and the patient can walk out of the recovery room and go home the same day as the procedure.
Do you have a recent patient success story to share?
One patient had her left side done in June and felt so good she came back in September to have the other side done! She is very happy and back to her very active lifestyle.
Anything else you’d like current or future patients to know about this procedure and how it could benefit them?
This is a very minimally invasive procedure with minimal downtime. The pain from the procedure is minimal. Unfortunately, intense activity is limited for 6 weeks but patients are up and walking the same day. Fusions sound really big and dangerous, but it is essentially a stabilization procedure. SI joints are often painful due to excessive movement. The SI stabilization procedure takes away the additional movement and helps return the patient to a normal functioning joint.For patients grappling with chronic lower back pain caused by SI dysfunction, the SI Fusion procedure can provide long-term pain relief and renewed quality of life. If you suffer from pain that hasn’t responded to non-surgical treatments, schedule a consultation with Dr. Lehn to explore whether SI Fusion is right for you. Take your first steps toward a pain-free future!