Sacroiliac Joint Fusion May Be Better Than Nonsurgical Treatments

If you have sacroiliac joint pain, you know how painful it can be.

Pain from damage to the sacroiliac joint, either from infection, bone disease, or simple wear and tear may result in severe, often intractable,chronic lower back pain. Since the sciatic nerve runs near this area, problems with the sacroiliac joint may be felt from the hips to the toes. Unfortunately, treatment options for sacroiliac joint disease have been limited and of limited effectiveness.

Treatment for sacroiliac joint pain has often been composed of nonsurgical methods, primarily physical therapy, injections with steroids to relieve inflammation, oral analgesics or steroids, and elimination of infection or other disease processes. These interventions can be helpful, but they are not helpful for all individuals, and their success may be short-lived.

The sacroiliac joint is one of the prime weight-bearing structures in the human body, and as such maintains a high degree of stability. The joint is kept in position by ligaments that are some of the strongest in the body. This makes sense considering the tremendous forces that the joint has to resist to maintain posture, and during walking and running.

Even a small misalignment can cause difficulty in movement. Like all synovial joints, the sacroiliac joint can be compromised by aging or trauma. If the joint is too mobile, or insufficiently mobile, the entire musculature of the back and pelvis can suffer. The standard of care is to try to improve functionality and reduce inflammation with physical therapy and injections; however, surgery may be a viable alternative. In fact, new data suggest that sacroiliac joint fusion may be superior in certain patients.

Sacroiliac joint fusion involves the placement of permanent stabilizing rods into the sacroiliac joint to take up the slack caused by weakened ligaments, muscles, or a damaged synovial capsule. The implants also steady the joint and help transmit the energies of movement correctly.Implants are made of titanium and designed to become a permanent part of the joint structure. Fusion insures that the mobility of the joint remains optimal regardless of the strength of the ligaments and muscles that typically take on the role of stabilization.

Sacroiliac joint fusion can be accomplished in about an hour. A stay of one or two nights in the hospital is common after surgery, depending on the patient’s overall health and age. As with nearly any major spine surgery, the period of postoperative rehabilitation is required.

Recent studies seem to indicate that joint fusion surgery for sacroiliac joint dysfunction may be superior to nonsurgical treatment in select cases.There is some evidence that inflammation of the sacroiliac joint can be reduced when the joint is kept in proper alignment over time. Surgical fusion of the joint may also provide a permanent solution to the issues arising from a weakened joint.

While additional studies are needed, sacroiliac fusion surgery should be considered for the treatment of sacroiliac joint problems alongside non-surgical treatments.

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