Surgical Treatment When Conservative Measures Fail

Patients suffering from sacroiliac joint pain are all too familiar with the miserable low back, hip, groin and leg symptoms that make everyday function difficult. In some cases, sacroiliac mediated pain can be treated conservatively with rest and self-care, icing, physical therapy, non-steroidal anti-inflammatory or pain medications and pelvic bracing. When nonsurgical treatments prove ineffective and quality of life is drastically impacted by daily SI pain, Princeton Brain, Spine & Sports Medicine surgeons may recommend sacroiliac joint fusion surgery.

About Sacroiliac Anatomy & Pain Causes

The triangular bone below the lumbar (lower) spine is called the sacrum. While most of the spinal vertebrae move, the sacrum is comprised of five immovable vertebrae. The two large bones forming the pelvis are called the iliac bones. The sacroiliac (SI) joints are the connectors for the sacrum and iliac bones. Unlike most other joints in the body, the sacroiliac joints move very little. Instead, they serve as stabilizers and shock absorbers between the upper and lower body, as well as supporting the weight of the torso during standing. These tasks impose a great deal of stress on the SI joints, so it is relatively common for arthritis to form as joint cartilage wears.

In addition to arthritis, sacroiliac joint pain may also be caused by joint inflammation, hypermobility, hypomobility, gait issues, pregnancy or injury. This SI joint dysfunction or degeneration leads to a variety of symptoms, including:

• Significant lower back pain
• Pelvic, groin & hip pain
• Pelvic & low back instability
• Increased pain from standing to sitting
• Exacerbated pain after standing or sitting too long
• Numbness or tingling in hip & leg
• Pain radiating into the thigh
• Hip & leg weakness

SI Joint Fusion Surgery: What Is It?

Surgery is a last-resort treatment for sacroiliac pain and dysfunction. However, when conservative treatments fail to bring SI joint pain relief and quality of life is impacted to a significant degree, our NJ neurosurgeons may recommend minimally invasive SI joint fusion surgery. During the fusion procedure, surgeons use screws, rods or bone graft to fuse the ilium and sacrum and eliminate joint motion.

Princeton Brain, Spine & Sports Medicine uses a minimally invasive surgical method for sacroiliac joint fusion. Traditional (open surgical) SI fusion takes far longer to heal and leads to higher complication rates. During the minimally invasive procedure, your physician will make a small incision in the side of the buttock and move the gluteal muscles to reveal the ilium. Using precision surgical tools and fluoroscopy imaging to guide the procedure, surgeons insert the instruments or the bone graft that will heal to fuse the pelvis and lower spine. The incision is closed and sutured, and recovery times are notably less than open surgery requires.