Just wondering if anyone on here has had issues with SI Joint dysfunction. I have had enormous pain for over 4 years now. I have had 2 lumbar fusions at l4-l5 and l5-s1. They were done to try and alleviate the extreme pain in my low back and hip pain with sciatica. They had did the discograms and all diagnostic tests to see if the disc were my pain generators and all were positive. After the 2 TLIF fusions with hardware my Pain had not resolved yet gotten worse in the SI Joint area and my buttocks and groin hurt to a point I needed a walker and crutches to move about. After all the injections and RFA in my left SI Joint they determined that a fusion would be the best route to go. They will be doing the IFUSE by SI Bone next week try and stop the dysfunction. My right joint has also gotten worse but not to the point of surgery yet. My concern is that being fused at 2 levels and now my left SI Joint that my right SI joint will need fusing rather quickly due to the stresses being put there. Is there any of you that have any experience with SI joint dysfunction, sacroiliitis, or any types of SI Joint fusions? Is there a possibility that I may need the other side done or another level of my spine? Seems like when I think I can't hurt any more and nothing more needs done surgical I get slapped in the face. I have been unable to work since 2007 due to these issues and just recently had a disability hearing with ALJ and should get my approval letter soon. That is the only positive thing that has happened from this since it started. I would love to hear from anyone who has had fusions that didn't alleviate the symptoms intended to. Any one with SI Joint issues or experience with the IFUSE procedure. Thanks a lot
Re: Newbie with ? about SI Joint dysfunction/Fusions
Welcome to the board. The SI Infuse is a new procedure, so be sure to determine that your surgeon has experience beyond training films doing the procedure. I do not have any personal experience with SI joint fusion, but I would think you could almost count on needing the other side done at some point.
One reason the SI joints develop problems to begin with is due to the increased stress put on them after lower lumbar fusion. I would think that fusing one side would just create additional stress on the side that is now the only movable joint from L3 to your buttocks. I think it will be very important that you work with a talented PT after the surgery to make sure you are not compensating for the lack of movement on the one side.
I would also be concerned that all your pain may not be coming from the SI joints but that the TLIF procedure is itself responsible for at least part of your pain. One unnwanted side effect that is becoming more apparent now that the TLIF has been around for a few years and more people are having the procedure is that some patients have a great deal of groin pain. The side effects have just begun being reported beginning with studies published in 2011.
The pain is due to the retraction that is done in order to accomplish this minimally invasive route into the spine. Access requires blunt dissection through the psoas muscle and the traversing lumbar plexus. Furthermore, a traction neuropraxia can occur because of pressure on the lumbar plexus by the expandable cannulas used to perform an XLIF. These groin injuries seem to be particularly common when the L5-S1 segment is part of the XLIF.
In most patients these injuries eventually heal and the pain and numbness go away, but there are reports of permanent damage in some patients.
It would be disappointing to go through the SI joint fusion only to later find out that your pain was coming from the XLIF fusions, and damage done to the femoral nerve, psoas muscle, etc.
Re: Newbie with ? about SI Joint dysfunction/Fusions
Thank you very much for the insight. I will be having the surgery done by the same group of neurosurgeons, but a different surgeon. They are a very good group of surgeons and all are surgeons at Duke medical which IMO one of the top Hospitals in the country. This particular surgeon has performed more than 30 SI Joint fusions using the IFUSE from SI Bone. I really trust his ability. He has told me NO weight bearing for 12 weeks and a lot of PT after that. Fusion normally occurs by 15 months. I never considered what u said about the problems after the TLIF fusions. Very interesting info.. I hope just the 1 fusion will be necessary on the SI Joint. I will keep my hopes up!! Once again TY!!
Re: Newbie with ? about SI Joint dysfunction/Fusions
Wow....so sorry that you have such problems. I had the traditional SI joint fusion surgery....it failed....did not fuse. So approx. 2 yrs. ago, I had the SI Infuse surgery on my right SI joint. It is a much easier fusion surgery over the traditional surgery. BUT, you do have to keep to the no weight bearing after surgery. I no longer have the pain down my right leg.....I do have pain in my SI joint area...I think because of the first surgery...the destruction of the SI joint...that it is bound to have pain there...the SI Infuse is 3 rods place across the joint...much less invasive...and less painful...seriously.
As to the issue of what happens with the opposite SI joint...hum...I am wondering myself...2 years out...and I am having pain issues...on the left side...is it periformas, disc or SI joint issues?????? I am not sure....I wish I had had the Infuse surgery first...I think that it would have healed much faster/less pain and less issues later...(is there scarring? Fusion?) I would not have walked around for 18 months with an unfused SI joint...what damage did that cause? If you are in serious pain...have done everything you can do...injections/thereapy etc. and no pain reduction....you have a decision to make....live like you are or give the Infuse surgery a chance. I am trying to get myself worked up to go and see my surgeron.....see what he says...but you do have to understand ....this would be a 3rd surgery for me.... Good luck....do what you feel is good for you...listen to the Doctor...do what he says...and you should be ok...remember...I was one of the 1st ones who had this surgery....they improve with time..
Sage
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Re: Newbie with ? about SI Joint dysfunction/Fusions
No weightbearing for 12 weeks -- wow, that is a LONG time.
I'm glad you are with an experienced surgeon. So many patients just assume their surgeon is well-experienced with a new procedure and would be shocked to know that isn't the case.
Re: Newbie with ? about SI Joint dysfunction/Fusions
sorry I took so long in replying....I could not walk....bear any weight on the surgery side for up to 3 months....I was on a walker..basically had to do a bunny hop...not pretty...My husband bought me an electric "buggy" before the 2nd surgery..he realized how difficult it was for me to manuver about. It was a blessing. My second surgery was 12/2010, and things may have changed......I was the first revision to use the new system!!! It has worked much better for me.....and the surgery would be a nothing compared to the first surgery....with all of the nuts and bolts and hardware...that was not pretty.... I feel that I did very well after the second surgery....approx. 90% of the pain is gone...I believe that if I had not had the initial surgery...where they basically chop up part of the sacrum, I would be even better. My leg, foot and toes no longer hurt...which is wonderful. I have a low backache...but after all I had...I can live with this. I ran into a nurse at the hospital where I had my surgery and she had the new surgery in Dec...and was back to work in Jan...amazing. I would do this again....if you have any more questions...give me a message!
sage
Re: Newbie with ? about SI Joint dysfunction/Fusions
Sage,Can you tell me who done your SI BONE surgery?
Ive been doing prolotherapy since last October every 4 weeks.My DR has stopped the injections this past Jan.I got probably 40-50% pain relief but the joint still moves some and I cannot stay on it for long periods at a time yet..90% and I could go back to work..Sounds like I do want the SI BONE fusion.I'm so glad you are doing so well with it.
Last edited by moderator2; 04-18-2012 at 07:28 PM.
Re: Newbie with ? about SI Joint dysfunction/Fusions
I wish you luck with your decision. It is not easy...but the end result is what counts...patience is needed for the recovery....every Dr. is different, and what they require. We all have our days....and the weather...but it is the end that counts.! Any more quesitons..just send a message!
The Following User Says Thank You to Sage48 For This Useful Post: Manta1 (05-14-2012)
Re: Newbie with ? about SI Joint dysfunction/Fusions
I can tell u about mine. It was done 2-8-12 and other than the 1st week I have felt more and more improvement in the SI Joint area where he put in the IFUSE impkants across the joint. My first week or so was absolute hell because when he had put in the top implant which is the longer one he was tapping on the 2nd implant with the hammer to push it over the screw they put the implant over. By doing this the pressure from the hammer moved the 2st implant in 3 millimeters and crushed the sciatic nerve. I woke up from surgery screaming so the next day i felt great since then as time has gone on. I still have a lot of pain back there but is tolerable. My next step is to have my R side fused in hopes of the same results.. Even having a freak accident crush my nerve and I FEEL LIKE i am dying it will be well wort it IMO..
The Following User Says Thank You to Bigphil For This Useful Post: Manta1 (05-14-2012)
Re: Newbie with ? about SI Joint dysfunction/Fusions
SiBone trained surgeon found!! Working on getting in to see him. Hope I can get in and he can help me. Not lookin forward to a walker but will gladly take it if it gets my life back in the long run.
Re: Newbie with ? about SI Joint dysfunction/Fusions
Manta, happy that you have found a trained SI joint physician! This is a good beginning. As far as using the walker...well, it is just part of the recovery....you have to remember that I had this surgery 2 1/2 yrs. ago...one of the first! So things change...but, follow your drs. orders....that is the best thing to do...and do not rush your recovery....that is very very important. I have some ache in my lower back..on the SI fused side...but I will take it...compared to the pain I had before....seriously...give yourself the proper time to heal....make it a priority....I know it is hard....but this is important...the rest of your life will thank you for it!! Rest, do not do anything your Dr. says not to...do not rush your recovery...that is the best thing that I can suggest to you... good luck!!!
Sage
The Following User Says Thank You to Sage48 For This Useful Post: Manta1 (05-15-2012)
Re: Newbie with ? about SI Joint dysfunction/Fusions
If you call SiBone's company from their website and tell them where you are,they can match you up with a trained physician nearest to you if the SiFuse system is the system you are interested in.Note:Since i found this surgeon,(we met finally this past FRIDAY!!! WOOT!!) I have found there are several ways that this joint is being fused with gobs of varying results lol..not always good results either.Seems it is a crap shoot.
Re: Newbie with ? about SI Joint dysfunction/Fusions
Basically any SIJ fusion prior to this new development, the SI Bone fusion, has not had very high rates of success. The SI Bone technique seems to be promising, but it is new enough that there is no long-term data on it.
As with any surgical procedure, it is important to get several opinions and to determine as much as you can that it is the right procedure for the issue.
Re: Newbie with ? about SI Joint dysfunction/Fusions
Quote:
Originally Posted by jpilgrim447
hI mANTA, WHAT PHYSICIAN HAVE YOU LOCATED TO DO YOUR SI JOINT FUSION? THANKS! I AM IN NEED OF ONE IN SOUTH FLORIDA. THANK YOU FOR YOUR HELP.
I am in middle Ga. You can call up the company that makes IFuse and ask for a referral. They can locate a trained physician nearest to you.I don't think I can name names in this thread due to site rules.The company tho will gladly tell ya who uses their system..Is how I found this Dr.good luck to ya!
Re: Newbie with ? about SI Joint dysfunction/Fusions
Quote:
Originally Posted by teteri66
No weightbearing for 12 weeks -- wow, that is a LONG time.
I'm glad you are with an experienced surgeon. So many patients just assume their surgeon is well-experienced with a new procedure and would be shocked to know that isn't the case.
I hope the IFuse will resolve your pain issues.
my husband had the ifuse surgery on left side the upper leg pain is better but below his knee aand foot his pain is worse dr. says he needs other side fused. they are going to try injections first.its only been 2 months since surgery. any one had this problem.
Re: Newbie with ? about SI Joint dysfunction/Fusions
I had a bilateral SI fusions almost two weeks ago. My doctor got the insurance company to agree to bilateral due to fact that a second surgery would need to be done eventually. I have done well on a walker, am suppose to be on walker for 3-6 weeks, w/ no wt bearing. No wt bearing is impossible but I am trying. I have been told to get up for 10 minutes every hour, however, that is suppose to be increased as I heal.
My concern is that my doctor was very vague as to 'increase' activity, instructions were, can use stairs after 5 days - with no wt bearing??? I am a little confused and have started having sharp pain in my right buttock and am concerned that I need to stay down more often than not!! I really want this to work!!!! Loved my surgeon, but wasn't thinking clearly about post op instructions, was just waiting for follow up appt, but that is not for another month! Anyone else w/ this experience?
Re: Newbie with ? about SI Joint dysfunction/Fusions
Did you have the I-Fuse procedure?
I would suggest you call your surgeon's office tomorrow morning for more specific instructions. You want to be really careful with stairs because that stepping up process really puts increased pressure on the one leg as you make the step. With my last fusion I was told to limit the trips up and down stairs to twice per day -- coming down for the day and going back up to go to bed...for at least the first six weeks.
One day, I was so sore...about six months post fusion. I had been using a small step-stool to wash cupboards in my daughter's new apartment -- just one step up and down...but it was enough to create a great deal of pain. It was explained to me that the mechanics of taking a step up or down put so much stress on the joints, etc.
You need to try to nip whatever is causing this pain quickly...SI fusions do not have a high rate of success in general...so try to stay on top of any new pain. It is important to walk as it is what helps to keep scar tissue from attaching to the nerves as it forms and fills in during the period of initial growth -- the first twelve weeks post surgery.
