Our Summary

This research paper looks at how lower back surgery can lead to problems with the sacroiliac joint, which connects the lower spine to the pelvis. The study used a number of databases to look at research from the last 10 years. The results showed that around 7% of people who had lower back surgery developed new problems with the sacroiliac joint. It was also found that this issue was more common in people who had a certain type of lower back surgery, had surgery on three or more spine segments, and in men. The study found that the use of injections into the joint reduced pain by 75%, and a treatment called radiofrequency ablation reduced pain by 90%. The use of a system called iFuse to fix the joint also showed good results. The research suggests that lower back surgery can impact the biomechanics of the sacroiliac joint, leading to problems. It also notes that diagnosing this issue can be complex, and new techniques may be needed. When usual treatments don’t work, radiofrequency ablation and iFuse can be effective.

FAQs

  1. What percentage of people develop new problems with the sacroiliac joint after undergoing lower back surgery?
  2. What treatments were found to be effective in reducing pain caused by problems with the sacroiliac joint after lower back surgery?
  3. Why are new techniques potentially needed to diagnose issues with the sacroiliac joint after lower back surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about joint fusion is to follow a comprehensive rehabilitation program after surgery to ensure proper healing and prevent complications. This may include physical therapy, exercises to strengthen the surrounding muscles, and proper pain management strategies. It is important to follow all post-operative instructions provided by your healthcare team to optimize your recovery and long-term joint function.

Suitable For

Patients who are typically recommended joint fusion are those who have persistent pain and dysfunction in the sacroiliac joint following lower back surgery. This may include individuals who have undergone a certain type of lower back surgery, had surgery on multiple spine segments, or are male. Additionally, patients who have not responded to conservative treatments such as injections and physical therapy may be candidates for joint fusion. Overall, joint fusion may be recommended for patients who have not experienced relief from other treatments and continue to experience significant pain and limitations in daily activities due to sacroiliac joint dysfunction.

Timeline

Before joint fusion:

  1. Patient experiences lower back pain and undergoes lower back surgery.
  2. Around 7% of patients develop new problems with the sacroiliac joint.
  3. Patients may experience ongoing pain and discomfort in the lower back and pelvis.

After joint fusion:

  1. Patients may receive injections into the sacroiliac joint to reduce pain by 75%.
  2. Radiofrequency ablation treatment can reduce pain by 90%.
  3. The use of iFuse system to fix the joint shows good results in reducing pain and improving function.
  4. Diagnosis of sacroiliac joint issues can be complex and may require new techniques for accurate assessment.
  5. When traditional treatments are ineffective, radiofrequency ablation and iFuse can be effective options for managing pain and improving quality of life.

What to Ask Your Doctor

  1. What exactly is joint fusion and how does it work?

  2. What are the potential risks and complications associated with joint fusion?

  3. What are the success rates of joint fusion surgery for my specific condition?

  4. How long is the recovery process after joint fusion surgery?

  5. Are there any alternative treatments or therapies that I should consider before opting for joint fusion surgery?

  6. Will I need physical therapy or rehabilitation after the surgery?

  7. What type of follow-up care will be required after joint fusion surgery?

  8. How long can I expect the results of joint fusion surgery to last?

  9. Are there any specific lifestyle changes or precautions I should take after joint fusion surgery to prevent future issues?

  10. Are there any specific factors that may increase the likelihood of developing problems with the sacroiliac joint after lower back surgery, and how can they be minimized or addressed?

Reference

Authors: Karimi H, Rodrigues R, Patel S, Patel J, Kosarchuk J, Kryzanski J. Journal: Acta Neurochir (Wien). 2024 Jan 27;166(1):43. doi: 10.1007/s00701-024-05918-1. PMID: 38280117