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SI joint pain after fusion

smartenssmarten Posts: 8
edited 06/11/2012 - 8:51 AM in Sacroiliac (SI) Joint Problems
Ongoing pain after fusion surgery is an important topic in our patient community.

Here's a question about ongoing pain related to the SI joint:

"I have heard SI joint inflammation can happen after fusion surgery, what causes this?"
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Comments

  • The level or levels thats fused has no more movement. Which will cause the level above and bellow the fusion a lot more stress which ends up with si joint ainflamation. With each movement after fusion the other levels are taking much more of a beating then before being fused. I haven symptoms i never had after fusion at my l4l5. Without having the cushion of the removed disc where fusion took place will put much more stress on the si joint i am sure. Kind of like removing the shocks and springs off your car. It will still run but wont drive like a new car that has new springs and shocks

    Alex"
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • According to a study by Ha, et al, lumbar fusion patients have been shown to have a higher incidence of SI joint degeneration than non-fusion patients.5

    •The incidence of SI joint degeneration in patients was 75% at 5 years post-fusion, which was significantly higher than in the non-fusion group, 38.2%.
    •Among patients with one-segment fusion, 91% developed SI joint degeneration.
    •Regardless of whether the fusion includes the sacrum, the SI joint is influenced by increased mechanical stress arising from lumbar/lumbosacral fusion.
    •Posterolateral lumbar/lumbosacral fusion can be a cause of SI joint degeneration.

    These data may imply that:

    •Patients who are still symptomatic after lumbar spine surgery may have actually had SI joint problems instead of or in addition to another spinal problem
    •Patients who have had prior lumbar spine surgery may develop issues with their SI joint
    •The increasing incidence of SI joint problems supports the inclusion of the SI joint in a differential diagnostic work-up of patients with low back pain.


    5 Ha, et al. Degeneration of Sacroiliac Joint After Instrumented Lumbar or Lumbosacral Fusion: A Prospective Cohort Study Over Five-Years Follow-Up. Spine (Phila Pa 1976). 2008 May 15;33(11):1192-8.

  • hmmm...I wonder if that is what could be happening to my left hip.
  • Something I did not see is that, I have screws very low close to my SI joints and feel this irritates the nerve roots close to the SI joints.

    I also had misalignment of my SI joint by pressing on the brake trying to avoid hitting a car in the car accident I had.

    I did not find this out, until seven months after my fusion and by a physical therapist (myofascial) and it took one month to adjust.

    My physical therapist states you can do this by stepping off a curb.

    Your SI joint is close to your piriformis muscle, sciatic muscle and how they relate when you walk or do
    anything physical.

    I wear a sacral iliac belt to immobilize my si joint and it is a simple method to prevent pain.

    I would like to see the difference of surgery with and without instrumentation as I believe instrumentation causes a unnatural curvature of the spine placing stress on the SI joint. If you do not have strong abdominal muscles, you place more stress on your trunk.

    So, yes, I believe the instrumentation of the fusion causes the pressure on the SI joints causing a SI syndrome that involves the piriformis muscle, sciatic, and SI joint.

    So that's my opinion from my experience and medical records. BJ
  • All fusion rods by now should have spring loaded at least to take the shock and allow some movement. If you ask me this is a no brainer and i dont know why the medical field has not come up with anything as such. Even the adr does not handle the load even if it does allow movement. With the rate of disability in the usa. You would think the brain power would kick in and they would have developed much beter way to fix the spine then sticking screws and rods or adr when neither acts as the disc they took out.

    Look at the technology going in to cars and iphones and computers but nothing for humans for beter life and less suffering. I dont mind having screws drilled in my spine if its something that you know will help by replacing the bad disc and you live pain free. But how can anyone be pain free by these surgeries when none of this hardware is anywhere close to acting as the natural replacement for a human disc?

    You go in to surgery with 1 type of pain and you come out of surgery with 50 types of pain they cant explain. Or they tell you whell surgery went great you are fused perfect. In my view a surgery is not a success as they like to think unless person came out of surgery and has slight normal pain expected as from any other surgery.

    Only a dr can have this kind of thinking that he did a good job and gets paid for it. That would be like me building a house but the roof caved in but i still want to get paid because the walls are still standing. Alex
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • After my fusion, I have lots of SI joint pain now, particularly in cold wet weather.

    There seems to be a lot of inflammation in that area, scar tissue or perhaps what some of your mentioned above when I look at the MRI.

    I just did a spinal injection, oh what great fun.. but seems to calm things down for about 3 months. I also do pilates stretching and my neuro stimulator seems to help. I also did Feldenkreis which for some reason make a big difference in lots of ways. Just started it, so we will see.

    Australia actually seems to be doing more research on chronic pain and back issues so you might want consider looking at research from there.

    It is scary how little they understand about chronic pain and/or back issues.


    Yet, what can you do, suffer and grin and bear it, or do the surgery and hope for the best? I am not sure what the best choice is, for everyone it is different.

    I am working hard to come up with a defined tracked pain management plan that records every treatment, alternative treatment ie non Western medicine or otherwise so I can create a tangible Action Plan around my back. It is hard for me at least, to keep track of what is working and what is not!

    Wendy

  • In dec 2010 I had my right si joint fused using ifuse, my own bone shavings and 2 screws, 3 1/2 inches long. I was non-weight bearing for 3 months. Once I recovered from the surgical pain, I had more painfree days than I had in 6 yrs. Then on day it all came back, plus some. The fusing is ongoing and is within good margins for 5 mths. Yesterday my dr told me he wants to remove the screws because he believes they are causing nerve irritation, this being the cause of my terrible si pain and pain down my leg. My question is this; is this surgery just minor surgery and I can just get up and go afterwards, or will there be a long recovery and non weightbearing again? Any information would be appreciated. I only thought of these questions after I left!
  • In dec 2010 I had my right si joint fused using ifuse, my own bone shavings and 2 screws, 3 1/2 inches long. I was non-weight bearing for 3 months. Once I recovered from the surgical pain, I had more painfree days than I had in 6 yrs. Then on day it all came back, plus some. The fusing is ongoing and is within good margins for 5 mths. Yesterday my dr told me he wants to remove the screws because he believes they are causing nerve irritation, this being the cause of my terrible si pain and pain down my leg. My question is this; is this surgery just minor surgery and I can just get up and go afterwards, or will there be a long recovery and non weightbearing again? Any information would be appreciated. I only thought of these questions after I left!
  • My SI joint pain showed it ugly face after my double spinal fusion. It is really hard to cope with particularly when there is a weather change.

    Do you find that to be the case, I am a pain weather barometer? I have had to move because I can't stand cold rainy weather, it was so painful.

    Wendy
  • For some reason they are more progressive in OZ than in the USA particularly around back pain. I am always looking for the latest and greatest. Of course I would have to pay for it out of pocket, but if I really think it would work, what is the price of a more pain free life?

    Wendy
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