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 during walking from reaching the spine.
Like any other joint in the body, the SI joint can become damaged or its support ligaments can become loose or injured. SI joint pain or SI joint dysfunction can be due to a number of conditions, including degeneration, disruption, inflammatory conditions such as ankylosing spondylitis, tumor, infection or other problems. When this happens, people can feel pain in their upper leg(s), buttock and sometimes even higher on the axial skeleton.This is especially true with sitting, lifting, running, walking or even sleeping on the involved side. In all of these cases, the symptoms can be felt anywhere from the upper leg to the lower spine.
It is important to note that on occasion, patients who have not experienced symptomatic relief from lumbar spine surgery may actually have had SI joint problems to begin with or have problems with the spine and SI joint. In addition, patients who have had prior surgery may now have adjunct issues with their SI joints.
A variety of tests performed during physical examination may help reveal the SI joint as the cause of your symptoms. In addition, X-rays, CT-scan or MRI can be helpful in the diagnosis of SI joint-related problems. It is also important to remember that more than one condition (like a disc problem) can co-exist with SI joint 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.Your surgeon will deliver the injection with either fluoroscopic or CT guidance to verify accurate placement of the needle in the SI joint. If your symptoms are decreased by a minimum of 75%, it can be concluded that the SI joint is either the source, or a major contributor, to your low back pain. If the level of symptomology 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. Some patients respond to physical therapy, use of oral medications, as well as injection therapy. Intermittent use of a pelvic belt may provide symptomatic relief as well. These treatments are performed repetitively, and frequently symptom improvement using these therapies is temporary. At this point, you and your surgeon may consider other options, including surgery.
The iFuse Implant System is a minimally invasive surgical option for sacroiliac joint fusion for conditions including sacroiliac joint dysfunction that is a direct result of sacroiliac joint disruptions and degenerative sacroiliitis. The procedure typically involves three small titanium implants surgically inserted across the SI joint, and is designed to create a durable construct to stabilize the SI joint. The procedure is done through a small incision and takes about an hour.