12 Jul Basics of Minimally Invasive Sacroiliac Joint Fusion
The sacroiliac (SI) joint is a large joint in the pelvis connecting the sacrum and ilium in the pelvis. The SI joint functions as a weight bearing joint and as a shock absorber for the spine. Like other joints in the body, it is stabilized by strong internal and external ligaments. This joint can become loose causing pain to the patient. This pain can radiate to the hip, buttocks, and all the way down the back of the thigh. Since the SI joint is related to many large and small muscles, all these can be affected causing inflammation and dysfunction.
Although there are many patients who experience SI joint pain, the recommended treatment for it is conservative treatment which involves physical therapy, injections in the joint, hot or cold therapy. The traditional open surgery for this requires large incisions, bone harvesting, and long hospital stays and recovery time.
Using the minimally invasive keyhole SI joint fusion procedure, patients enjoy the advantages of less scarring due to smaller incisions, less blood loss, shorter hospital stays, and faster recovery time. It also avoids the necessity of bone harvesting, hence preserving both bone and ligaments. It is also suitable for the elderly. This is important as about 38% of patients with SI joint pain are over the age of 65 years old. This group is not likely to respond well to conservative treatment such as physical therapy due to the degenerative nature of the condition.
The procedure aims to stabilize the SI joint to be strong enough for activities such as standing, walking, and running. The surgeon accesses the SI joint using a small incision in the back. Using specialized instruments, the sacrum and pelvis is fused to ensure it is stable enough to support the spine and to decompress the nerve that is affected.
Patients go under general anesthesia for the procedure. After the surgery, patients are moved to the recovery area until they regain consciousness. They usually stay in the hospital for another day and any pain or discomfort can be managed using intravenous pain medication. Patients are then discharged with oral medication for pain when they can return home the next day.
All patients should be made to understand that physical therapy is a must before going through surgery. They may require the use of crutches or a cane to help them walk for several weeks after the surgery. The physical therapist will guide the patient in learning how to get out of bed, sit, or walk before being discharged. It is also ensured that their bowels and urinary system is working normally. Ultimately, they must be able to learn how to be partially independent before going home.
Current literature has shown that minimally invasive keyhole SI joint fusion has good outcomes with 82% of patients saying that they were satisfied 5 years after the surgery. Other researches have also reported that the patients saw significant improvements in pain and function. A recent publication stated that 98% of their patients experienced clinically significant benefit 12 months after the surgery with minimal complications. This procedure is especially important for the elderly population as it may provide them an opportunity to regain mobility and improved quality of life.
Inspired Spine’s surgeons offer minimally invasive keyhole options for the relief of back and SI joint related pain. This includes the minimally invasive keyhole SI joint fusion. Call us today to find out how the Inspired Spine physicians can help you! Most insurance accepted.
- Sachs D, Capobianco R. Minimally invasive sacroiliac joint fusion: one-year outcomes in 40 patients. Advance Orthopedics. 2013; 536128. doi: 10.1155/2013/536128
- Sacroiliac joint fusion. SpineMD. Accessed 6/22/2017. https://www.spinemd.com/treatments/sacroiliac-joint-fusion