Sacroiliac Joint Fusion (iFuse)
Sacroiliac Joint Fusion (iFuse)
The sacroiliac joint (SI joint) is located in the pelvis; it links the iliac bones (pelvis) to the sacrum (lowest part of the spine above the tailbone). It is an essential component for shock absorption to prevent impact forces from reaching the spine. Many problems can cause SI joint pain. The SI joint is a significant cause of low back pain. Clinical publications have identified the SI joint as a pain generator in 15-30% of chronic low back pain patients. In addition, the SI joint is a pain generator in up to 40% of patients with continued or new onset low back pain after a lumbar fusion.
Like any other joint in the body, the SI joint can be injured and/or become degenerative. A sudden or traumatic injury, an existing condition (differences in leg length, twisted pelvis or muscle imbalance), an inflammatory joint disease or hormonal changes during pregnancy can all cause SI joint pain. When this happens, people can feel pain in their buttocks and sometimes in the low back and legs. This is especially true while lifting, running, walking or even sleeping on the involved side. It’s common for pain from the SI joint to feel like disc or low back pain. For this reason, SI joint disorders should always be considered in the diagnosis of such pain
Do you experience one or more of the symptoms listed below?
• Low Back Pain
• Numbness, Tingling or Weakness
• Pelvic/Buttock Pain
• Hip or Groin Pain
• Pain Radiating Down One or Both Legs
• Feeling of Instability in the Leg (buckling)
• Difficulty in transition from Sitting to Standing
• Problems sitting especially for long periods of time
• Disturbed Sleep Patterns due to Pain
A variety of Orthopedic, Neurological and Musculoskeletal tests will be performed during a Comprehensive Physical Examination which may help reveal the SI joint as the cause of your symptoms. In some cases, X-rays, Diagnostic MSK Ultrasound or MRI may be helpful in the diagnosis of SI joint-related problems.
The most relied upon method to accurately determine whether the SI joint is the cause of your low back pain symptoms is to inject the SI joint with a local anesthetic. The injection will be delivered under either Fluoroscopic guidance to verify accurate placement in the SI joint. If your symptoms are decreased by at least 50%, it can be concluded that the SI joint is either the source of or a major contributor to your low back pain. If the level of pain does not change after SI joint injection, it is less likely that the SI joint is the cause of your low back pain.
Once the SI joint is confirmed as the cause of your symptoms, treatment can begin. Most patients respond to Physical Therapy, Chiropractic, Acupuncture, Injections, Medication Management or Bracing. If these treatments are performed frequently with only mild symptom improvement then you may want to consider another treatment option. At this point, our Board Certified Physician may consider other options, including SI Joint Fusion with the iFuse Implant.
SI Joint Fusion with the iFuse Implant System®
The iFuse Implant System is designed to provide stabilization and fusion for certain SI joint disorders. This is accomplished by inserting triangular shaped titanium implants across the sacroiliac joint to maximize postsurgical stability and weight bearing capacity. The procedure is done through a small incision (about 2-3 centimeters long) and takes about an hour. Multiple published studies on iFuse have documented procedure safety and effectiveness and over 82% of patients indicated they were satisfied with both their short- and long-term results.
In addition to being minimally invasive, the procedure offers the benefits of a triangular implant, which minimizes rotation and micromotion that can cause more sacroiliac joint pain. Bone growth onto and into the implant is enabled thanks to a porous titanium surface, while the device is engineered to fuse and stabilize the joint. Our Double Board Certified Physician uses Fluoroscopy to obtain live images, so they can properly place the iFuse Implant System. Real-time moving images help to see internal biological structures and where the surgical instruments are.
Patients are discharged based on their progress and health status following the procedure. Some patients may be able to progress rapidly to full weight-bearing. Other patients may require a period of protected weight-bearing due to associated health conditions such as age, osteoporosis, altered bone health, impaired balance, and/ or gait, or other musculoskeletal conditions. You will also receive guidelines to ice the affected area to reduce any swelling, perform certain exercises including short periods of walking to keep up your strength and will be referred to our Physical Therapist.
At discharge the Physician will arrange follow-up visits to assess your progress and health status (including the status of your incision) and may take additional x-rays of your affected area. Usually the patient only needs to limit weight-bearing activities for a few weeks and full healing occurs in the 6-8 week timeframe.