Why choose a minimally invasive approach?
The word “fusion” can make patients picture a major spine operation. However, SI joint fusion does not necessarily require a large, traditional surgical procedure. A traditional approach may involve more extensive surgical exposure, greater disruption to surrounding tissues, general anesthesia, a longer initial recovery, and more significant postoperative restrictions.
Dr. Shamloo’s approach is designed to provide stabilization and fusion of the SI joint while minimizing disruption to the surrounding tissues:
The goal is to provide the stabilization and fusion the SI joint needs while minimizing the physical impact of the procedure and recovery.
What is the sacroiliac joint?
The sacroiliac joints are located where the sacrum and pelvis meet, on either side of the lower spine. These joints help transfer forces between the upper body and legs while providing stability to the pelvis.
When an SI joint becomes dysfunctional, inflamed, or unstable, patients may experience pain in the lower back, buttocks, hip, pelvis, groin, or upper leg.
SI joint pain can sometimes feel similar to pain caused by a lumbar disc problem, spinal stenosis, or hip disorder. This makes identifying the true source of the pain especially important.
What causes SI joint pain?
Sacroiliac joint dysfunction can develop for a number of reasons, including:
Some patients develop persistent SI joint pain without a single identifiable injury.
How do I know if my SI joint is causing my pain?
One of the challenges of SI joint dysfunction is that its symptoms can overlap with other conditions affecting the lower back, hip, and pelvis. SI joint pain may be:
A careful evaluation is essential because not all lower back or buttock pain comes from the SI joint. Dr. Shamloo evaluates your symptoms, examination, history, imaging, and response to diagnostic SI joint injections when appropriate.
When conservative treatment isn’t enough
Most patients with SI joint pain do not immediately need fusion. Treatment may initially include physical therapy, activity modification, medication, SI joint injections, targeted nerve blocks, or other interventional pain treatments.
For some patients, these treatments provide meaningful relief. For others, relief may be temporary or insufficient to control their symptoms.
When the SI joint has been identified as the primary source of persistent pain and conservative treatment has not provided adequate relief, minimally invasive SI joint fusion may become an option.
What the fusion involves
SI joint fusion is designed to stabilize the painful SI joint and encourage the bones on either side of the joint to fuse together. Dr. Shamloo uses a minimally invasive posterior approach to access the joint through a small incision, and a specialized implant is positioned within the joint to provide stability and support the body’s natural bone-healing process.
As the fusion develops, the goal is to reduce painful movement within the SI joint and create a more stable connection between the sacrum and pelvis. Dr. Shamloo currently primarily uses the Aurora Spine SiLO™ system, although the specific implant technology used may evolve as newer options become available.
Minimally invasive does not mean that the procedure is minor — the SI joint is still being stabilized and fused. It means the procedure is designed to accomplish the same therapeutic goal through a significantly less disruptive approach.
What is recovery like?
One of the major advantages of the minimally invasive approach is the relatively short initial recovery period. Most patients can resume most normal daily activities the following day.
For the first couple of weeks, patients generally need to follow specific precautions regarding bending, heavy lifting, and strenuous activity. These temporary restrictions help protect the treatment area while the initial healing process takes place.
It is important to distinguish between returning to normal daily activities and the biological process of fusion. While patients may feel comfortable and return to everyday activities quickly, the bone fusion itself continues to develop over time.
Who may be a candidate?
A diagnosis of SI joint dysfunction does not automatically mean that fusion is necessary. Appropriately selected candidates may include patients who:
Before recommending a procedure, Dr. Shamloo considers your symptoms, examination, imaging, diagnostic injections, previous treatments, overall health, and treatment goals.