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Old 01-31-2012, 11:26 AM   #1
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Newbie with ? about SI Joint dysfunction/Fusions

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

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Old 01-31-2012, 12:08 PM   #2
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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.

Is the same surgeon performing this new surgery?

 
Old 01-31-2012, 12:39 PM   #3
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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!!

Last edited by hb-mod; 07-19-2012 at 10:27 AM.

 
Old 02-01-2012, 06:38 AM   #4
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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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Old 02-01-2012, 08:36 AM   #5
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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.

I hope the IFuse will resolve your pain issues.

 
Old 04-07-2012, 07:50 AM   #6
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Re: Newbie with ? about SI Joint dysfunction/Fusions

when you say no weight bearing do you mean walk with crutches to stay off that side or wheelchair?

 
Old 04-18-2012, 04:04 PM   #7
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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

 
Old 04-18-2012, 04:13 PM   #8
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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 08:28 PM.

 
Old 04-19-2012, 07:38 AM   #9
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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!

 
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Old 05-14-2012, 10:00 AM   #10
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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..

 
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Old 05-14-2012, 03:18 PM   #11
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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.

 
Old 05-15-2012, 06:16 AM   #12
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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

 
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Old 07-19-2012, 01:33 AM   #13
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Re: Newbie with ? about SI Joint dysfunction/Fusions

Sage - Which surgeon is doing your SI Joint surgery this time around in Florida? Thanks!

I am in South Florida.

Last edited by hb-mod; 07-19-2012 at 10:27 AM.

 
Old 07-19-2012, 01:56 AM   #14
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Re: Newbie with ? about SI Joint dysfunction/Fusions

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.

 
Old 07-19-2012, 09:05 AM   #15
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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.

my surgeon is in the Macon,Ga.area.

 
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