Description of Procedure
Inspired Spine Sacroiliac Joint Fusion (SI Joint Fusion) is a minimally invasive surgery that uses highly engineered and specialized devices along with non-cadaveric bone graft to encourage bone growth over the sacroiliac joint, creating one immobile unit. Inhibiting movement stabilizes the Sacroiliac Joint and reduces inflammation, resulting in less pain in the Sacroiliac Joint area and the leg. Different FDA approved devices can be utilized depending on the preference of the Inspired Spine surgeon.
The procedure requires the use of general anesthesia and takes under an hour to complete. The SI Joint is accessed through a small incision from the lateral hip/buttock area. Using specialized instruments, muscles are dilated to create a safe path through them, the hip bone (iliac crest), and the Sacrum to deliver the fusion devices (usually 2 screws) to the sacrum and pelvis. The sacrum and pelvis are fused to create stability and support the weight through the spine, removing this from the pelvis and legs.
Despite its name, the “SacroIliac Joint” (SIJ) is not a true joint and has no known function in the human body. The correct term for this part of the body is a synostosis, which is the union or fusion of adjacent bones by the growth of bony substance. Instability in this synostosis is very common, and often leads to clinical symptoms including pain in the leg. Our current understanding is that irritation in the SIJ increases inflammation and irritates the web of nerves that passes down over the SIJ to the lower extremities. Current guidelines require a provocation test by your doctor, followed by 2-3 diagnostic SIJ injections with at least 75% repeated improvement after the injection.
Please see your primary care physician 10-14 days after surgery to have the incision examined. We would like to see you at Inspired Spine one month after surgery. These appointments are occasionally made for you prior to discharge from the hospital by the nursing staff. Please ask the nursing staff or contact our office to confirm these appointments. You should have a CT scan prior to your appointment to confirm the position of the hardware whenever you come back to the clinic for visits.
You can reach Inspired Spine at 727-MY-SPINE to set up an appointment.
Following surgery, you will be toe touch weight bearing for up to 4 weeks. You will receive a prescription for a walker or crutches from the surgical facility. During this period, do not bend or twist the spine. Remember the acronym “BLT”. That is, you should not Bend, Lift over 8 pounds, or Twist. Also, you should try to keep your back (hips to shoulders) as straight as possible. Do not lift over 8 pounds the first two weeks, then not over 16 pounds after that. Further restrictions will be clarified at your follow up appointment.
The medications prescribed at discharge may not last until your one-month follow up appointment. Please call Inspired Spine at 727-MY-SPINE for all refill requests. Please leave a detailed message including the name of the medication, dose and which pharmacy you would like to use. All medications will be monitored through the prescription drug monitoring program. Due to this monitoring, prescriptions will only be completed weekly on Tuesdays, as we require ample time for medication requests to be received and approved. Prescriptions can be picked up at our Alexandria location or mailed directly to the pharmacy. Since many prescriptions are for controlled substances, please expect drug screening to occur at random intervals.
Depending on the type of surgery, you may have staples, sutures, steri strips, or likely a combination of these to help keep your incision closed post-operatively. Steri strips are small stickers placed over the wound; please allow these to remain in place until they fall off on their own. Staples should be taken out within 10-14 days after surgery either with your primary care doctor or at our facility. Often a tan bandage is placed over the incision site after surgery. This is left on for 6 or 7 days, then should be removed. After this has been removed, gauze or bandages are usually not necessary. We ask that you leave the incision site open to air unless you find that there is increased sweat or moisture in the area, if this occurs dress the area 2 times per day until the environment is no longer moist or the 3 weeks have passed since surgery. Remember that dark and moist areas promote bacterial growth.
Signs of Infection
You or a significant other/caregiver should monitor your incision for signs of infection. Signs of infection include; redness, swelling, increased warmth to the touch, discharge from the wound, and a body temperature over 100.5 F. If any signs of infection do appear, please contact our office and/ or your primary care provider.
Things to Remember
Fluctuation in the amount of pain you may experience is normal. This is especially common 1-2 weeks after surgery related to increase swelling at the surgical site.
Certain things can delay your healing, hinder your surgery from being successful, and/or increase your risk of requiring another surgery. These include smoking and/or tobacco use, diabetes, poor general health, advanced age, and/or obesity. Although some risks cannot be avoided, it is important to control what you can for the best possible outcome. If you would like to quit smoking, your primary care provider can help.
Can I Bathe?
It is safe for the incision to get wet while taking a shower, but avoid any direct pressure from the shower head and do not scrub the area. Lightly pat the site dry with a clean towel when finished. Avoid submerging your wound by soaking in the bathtub, as this will increase your risk of infection at the incision site. Please wait around 3 weeks for the incision wound to heal before submerging the area while taking baths.
When Can I Drive?
Once you are off all narcotic pain medication, and have regained full control of your extremities you should be able to safely operate your vehicle.
When Can I Go Back to Work?
Most patients go back to work with restrictions 4-8 weeks after surgery. If your job is more physically demanding, this may need to be extended. In general, your capability to return to work will be discussed at your one-month visit.
Physical therapy can help you regain the ability to walk as quickly as possible. Early physical therapy will reintroduce activity in an appropriate and safe way. Physical Therapy is highly individualized and will be covered at your first postoperative visit.