A New Surgical Option for Low Back Pain
Most people will suffer from back pain at some point in their lives. While there are many causes of back pain, pain in the lower back can sometimes originate from the sacroiliac or SI joint. The SI joint links the pelvis to the lowest part of the spine above the tailbone.
SI joint disorders can be caused by injuries, age-related degenerative changes, previous lumbar fusion or other conditions. Pain due to SI joint disorders can occur on one or both sides of the low back, the groin, hip, thigh, buttocks and down the back of the leg. SI joint disorders can be easily misdiagnosed in patients because the symptoms are similar to other conditions such as a herniated disc or sciatica. “SI-mediated pain is really a condition that has more recently been recognized as a source of back and buttock pain,” said orthopaedic surgeon Peter G.Whang, MD, FACS.
Until recently, treatment for SI joint disorders has been non-surgical, involving physical therapy, pain medications or injections. A new FDA-approved surgical option uses implants to stabilize the joint. Dr. Whang is conducting a clinical trial to test how well this technique works compared to non-operative care.
“Establishing the correct diagnosis is critical to the success of this technique and something we take pains to address as part of this clinical trial,” he said. To diagnose this disorder, he injects dye and local anesthetic into the SI joint. This allows him to visualize the joint and to establish whether or not patients get some relief from the anesthetic. If they do, it suggests that their pain is coming from the SI joint.
The minimally invasive procedure involves placing three specially coated implants across the SI joint to eliminate motion. Special imaging techniques allow Dr. Whang to avoid making a large incision. “The advantage of doing it less invasively is that patients recover from surgery much more quickly because there’s not as much damage to the surrounding muscle and soft tissues,” he said.