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bonsterbbonster Posts: 3
edited 06/11/2012 - 8:59 AM in Sacroiliac (SI) Joint Problems
Hi I am new so I guess I will start with a brief story...I developed left hip pain only with touch and laying on it while pregnant so I ignored it from 07-09 My pcp in 09 sugested to see an ortho for injections I did not. Fast forward to June I went for a run and felt something in my hip not pain just off yet I continued and it went away. Then after working as a nurse I suddenly had severe pain. I saw my pcp who again told me to see ortho. Xray clean ortho gave me a steroid injection and ordered a mri of lumbar spine for low back pain radiating down left buttocks left thigh, hip and groin. Fast forward 2 More injections in hip, hopsital stay, multiple diagnosis that didn't pan out, mri hip lumbar spine, ct pelvis, si injection with steroid. Nothing worked pt, injectiond and 11 Drs consulted. Then I saw another spine surgeon who said he suspected sijd....one diagnostic injection confirmed it with immediate 100% temp. relief :) I am not able to work, off pt yet again on major narcotics for pain mantence and was told I need sibone fuse left side. The question....how does one decide to go with ifuse vs traditional fusion vs other methods???? I am lost, scared and need as much advice as I can get. Thank You!


  • Before proceeding with any additional treatment for the diagnosis of sacroiliac joint dysfunction you need to have a total of 2 diagnostic sacroiliac joint injections under xray guidance. During each injection contrast should be used to confirm needle placement, anesthetic should only be used (lidocaine or marcaine) a total of 1.0 to 2.0 ml of the anesthetic should be injected and there should be no leakage of contrast out of the capsule of the sij for fear of anesthetizing the L5 or S1 nerve root or other structures than just the SIJ that could be the source of your pain. If both injections are positive and you have failed conservative treatment for SIJ dysfunction I would recommend seeing a spine surgeon to discuss the possibility of an SIJ fusion using the Ifuse product. However it is important to rule out any lumbar spine abnormailities that could mimic your left sided symptoms. Hope this helps.
    Amish R Patel DO, MPH
  • Thank you for your response! I will be sure to tell my pain md to order another si diagnostic injection as u said. I have seen a surgeon who has already said he wants to do ifuse....but why I fuse vs traditional fixation? Could you list the conservative treatments I should do before going dorward since my spine md has already said it failed? I appreciate your taking time out to answer!!!!
  • I have seen the Ifuse case performed 4 times over the last 12 months. My impression is the ifuse is less invasive than the conventional open technique. Moreover the recovery time is much shorter and it seems patients are able to start walking is a much shorter period of time.

    As for conservative treatment options I would consider the following: Manual medicine under the direction of a physical therapist, osteopathic physician or chiropractor. Also a pelvic stabilization program under the direction of a physical therapist. I would also consider steroid injections into the sacroiliac joint 1-2 times if not performed. I would also consider an SIJ belt while performing activites to see if this helps with making the pain more tolerable with functional activity. Hope this helps.
    Amish R Patel DO, MPH
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