TREATING SI JOINT DYSFUNCTION YOUR WAY
The SAIL Fusion system was developed as a surgical treatment for chronic SI joint pain. It allows direct visualization of the joint via an intuitive, mini-open posterior approach that uses standard fluoroscopic images and positioning. The posterior approach is also able to avoid the neurovascular structures that are otherwise encountered in a transiliac approach. Access to the SI joint enables maximum decortication and a large bone graft. Tissue dissection is minimized due to less tissue covering the posterior sacrum.¹³
PATIENT PRESENTATION
While evaluating a patient, they may describe any or all of the following conditions:
Lower back pain
Radiculopathy down one or both legs
Pelvic pain, frequently inferior to the posterior superior iliac spine
Pain from standing, climbing, extended walking, heavy weights, standing on one leg, or long strides
Insomnia due to pain
Aching or shooting pains
Weakness or instability due to pain or numbness
DIAGNOSING SI JOINT DYSFUNCTION
Identifying the source of lower back pain can be difficult. Lumbar disc herniations and facet joint arthritis can cause similar symptoms. The following provocative tests can identify or rule out the cause of SI joint dysfunction²:
Sacral Thrust Test - Pressing on the back of the hips while laying prone on an examination table to induce pain
Distraction Test - Pressing on each hip while laying supine to induce pain
FABER Test - While lying supine, crossing the ankle over and above the contralateral knee, then pressing on the bent knee to induce pain or to identify limited range of motion
Palpation Tests - Pressing the thumb into the posterior SI joint along the length of the joint to induce pain. This should be correlated with other provocative tests
Additional Tests
Diagnostic Imaging - Identifying sources of lower back pain other than SI joint dysfunction
SI Joint Injections - Injecting a number solution into the joint to reduce pain at the source
TREATMENTS FOR CHRONIC SI JOINT PAIN
Physicians may follow a stepped approach to treating SI joint disfunction.
Initial Treatments
Conservative Treatment - Alternating ice and heat along with a few days of rest to reduce inflammation and discomfort
Pain Management - A moderate amount of pain relief can be achieved with over-the-counter NSAIDs. Physicians may also cautiously prescribe muscle relaxants or narcotic pain medications
Physical Therapy - Clinicians may be able to decrease muscle tension, spasms, and inflammation through targeted stretching, exercise, and massage
Surgical Treatments
Injections - A steroidal injection can reduce pain for up to six months. However, subsequent injections may be less effective
SI Joint Fusion - Studies have shown that posterior fusion of the symptomatic SI joint can significantly decrease SI joint pain with lasting results