Sacroiliac Joint Fusion : Sacroiliac Joint Fusion An Effective Treatment for Chronic Lower Back Pain

Sacroiliac Joint Fusion : Sacroiliac Joint Fusion An Effective Treatment for Chronic Lower Back Pain

Anatomy and Function of the Sacroiliac Joint Fusion 

The sacroiliac joint, also known as the SI joint, is a synovial joint that is located at the connection point between the sacrum and the pelvic bones. This joint is responsible for transferring weight from the spinal column into the pelvis and lower extremities. It allows for limited movement between the sacrum and pelvis which helps with walking, running and other physical activities. Proper functioning of the SI joint is essential for pain-free movement and mobility.

Causes of Sacroiliac Joint Fusion 

Several factors can disrupt the normal functioning of the SI joint and lead to chronic pain in the lower back and pelvic regions. Common causes of Sacroiliac Joint Fusion dysfunction include:

- Trauma or injury from accidents or falls where force is directed to the pelvis area.

- Repetitive stress from activities like running that place significant impact on the pelvis and lower back.

- Pregnancy changes the mechanics of the pelvis which can affect the SI joint.

- Lumbar spine problems like herniated discs that shift more weight and pressure onto the SI joint.

- Autoimmune diseases like ankylosing spondylitis that cause inflammation in the joints.

- Obesity increases wear and tear forces on the SI joint over time.

- Poor posture and pelvic imbalances put the joint under abnormal stresses.Symptoms of Sacroiliac Joint Dysfunction

The key symptoms of a dysfunctional SI joint include:

- Chronic lower back pain that may radiate to the buttocks, groin or thighs.

- Pain that increases with activities like walking, standing, sitting, bending or lifting weights.

- Unilateral or asymmetrical pain not always consistent on one side.

- Pain worsened by certain movements that stress the SI joint like hip extension, pelvic tilts or leg raises.

- Tenderness over the SI joint area aggravated by palpation or pressure.

Conservative Treatment Options

Mild to moderate cases of sacroiliac joint dysfunction are initially managed conservatively:

- Lifestyle modifications like weight loss, posture correction and stress avoidance.

- Over-the-counter pain relievers and anti-inflammatory medications.

- Physical therapy focusing on stretches and stabilization exercises.

- Chiropractic manipulation of the pelvis and SI joint may provide temporary relief.

- Orthotics or pelvic belts can help realign pelvic mechanics and reduce pain.

- Epidural steroid injections directly into the joint can reduce inflammation.

- Pro-inflammation medication may help in cases related to arthritis or ankylosing spondylitis.

When conservative therapy fails to relieve pain exceeding six months, surgical options are considered.

Sacroiliac Joint Fusion Surgery

For chronic, debilitating SI joint pain that does not respond well to non-operative measures, sacroiliac joint fusion (SIJF) surgery may be performed. The goal of this procedure is to permanently fix the SI joint using bone grafts and specialized surgical screws or plates so it can no longer move and cause pain.

Various surgical techniques have been developed for sacroiliac joint fusion over the years:

- Traditional Open Fusion involves making an incision over the buttocks and using bone grafts with plates or screws under direct vision through the open approach.

- Minimally Invasive Surgical (MIS) Fusion utilizes small incisions and fusion under X-ray guidance without dissecting muscles and tissues. The SI-BONE Fixation System is an example of an MIS device used for SIJF.

- Lateral Transiliac-Transsacral (LTT) Fusion is done purely through a lateral window created between the sacrum and iliac bones. Specialized titanium rods are used to fuse the joint.

Evidence and Success Rates

Large longitudinal studies, randomized trials and systematic reviews have demonstrated sacroiliac joint fusion to be a safe and effective surgical option for managing chronic SI joint pain. Here are some key findings:

- Success rates range from 74-90% based on significant reduction of pain 1 year post-op.

- One multicenter study reported 78% of patients experienced excellent/good outcomes at 2 years following MIS SIJF.

- Patients experienced an average pain relief of 70-80% and improvement in functioning after SIJF.

- Early minimally invasive techniques have led to less blood loss, shorter hospital stays and quicker recovery vs open procedures.

- Risks include non-union, infection, nerve injury and hardware issues though rare (less than 5% based on literature).

- Health-related quality of life and mental health scores significantly increased after sacroiliac joint stabilization.

For severe cases, sacroiliac joint fusion surgery provides a high probability of reducing chronic lower back and pelvic pain along with returning patients to normal activities. However, strict patient selection is important to maximize outcomes. With refinements in technique, this surgery continues to gain wider acceptance globally for treating sacroiliac joint disruption.

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Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)