Procedure to eliminate lower back pain

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Spine is fine: Richard Brinker (left), an 81-year-old from Burbank, is grateful that the SI joint fusion surgery done on him by George MIz, an orthopedic spine surgeon at Ingalls Advanced Orthopedic Institute, has eliminated the excruciating lower back pain Brinker suffered. | Supplied photo

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Is your SI joint the cause of your back pain?

When your sacroiliac joint is out of whack, you may begin feeling pain in the lower back, upper legs, buttocks and sometimes higher on the spine.

The most important information you can give to allow your doctor to know if it is the SI joint that’s causing the trouble is the exact location of your pain and level of your functionality. Try to notice when the pain occurs and how intensely you feel it in various locations, including your low back, buttocks, and legs.

Also, be sure to tell your doctor about any previous injury that may have either directly affected your pelvis, caused you to walk asymmetrically, or may relate in any way to your ability to function normally.

Your doctor will consider all information you provide, including any history of injury, location of your pain, and problems standing or sleeping. A variety of diagnostic tests may help determine whether the SI joint is a source of your symptoms. These include a physician exam, diagnostic imaging such as X-ray, CT scan or MRI, provocative tests, including manipulation of the SI joint, and diagnostic injections of the joint.

Provided by Ingalls Health System

The sacroiliac joint acts as a type of shock absorber for the spine, minimizing the impact caused by walking and moving around.

When the SI joint works well, all is good.

When it starts to wear down, however, a host of troubling symptoms can appear — including pain in the lower back, upper legs, buttocks and sometimes higher on the spine.

“The SI joint is a really strong joint that keeps us standing,” explains George Miz, M.D., orthopedic spine surgeon on staff at the Ingalls Advanced Orthopedic Institute. “And yet it is an underappreciated cause of pain in up to 25 percent of patients with lower back discomfort.”

The SI joint is located in the pelvis; it links the iliac bones (pelvis) to the sacrum (the lowest part of the spine above the tailbone).

“Over time, it can become disrupted or its support ligaments can become loose,” Miz added. “Symptoms may come on suddenly or develop gradually over time. In either case, people can feel pain in their upper leg(s), buttocks and sometimes even higher on the spine.”

This is especially true when sitting, lifting, running, walking or sleeping on the affected side.

For 81-year-old Richard Brinker, the pain was almost constant.

“When I would sit or lay down, the pain would creep up,” the Burbank retiree explained. “When I tried to walk, I’d go a few feet and would have to sit down. It became unbearable.”

Unfortunately, pain relievers like Tylenol offered about “three minutes of relief,” he added.

Brinker had a history of lower back problems. In fact, Dr. Miz performed a fusion surgery on his lower back in 2011. While it fixed that source of pain, Brinker continued to be troubled in the left SI joint area. Physical therapy and pain injections provided limited relief. After additional testing, the left SI joint was singled out as the cause of his problems.

That’s when Dr. Miz told Brinker about minimally invasive SI joint fusion, a procedure that uses titanium implants bolted into the pelvis to stabilize the troubled joint. Dr. Miz is one of the few surgeons in the state approved to perform this advanced procedure, and has done more than any other surgeon in the area.

“Instead of an open procedure, we place three pins through a small incision of about an inch,” he said. “We put them right through the pelvis and lock it into place.”

The pins are covered with a plasma spray to help the bone grow around and into the implant for more stability. Almost immediately, patients are up and walking.

Quick recovery

Another major difference is recovery time. For traditional fusion surgery, recovery can take up to six months; for minimally invasive joint fusion, it’s about two weeks.

Brinker underwent surgery at the Advanced Orthopedic Institute at Ingalls Memorial Hospital in Harvey in May. Within days, he was completely pain-free.

“I was up walking two hours after surgery,” he marvels. Within weeks, he was back to vacuuming and housework, he said with a smile.

“Dr. Miz is the only person I’ll ever let touch my back,” he adds. “I live closer to other hospitals, but I’ll come to Ingalls because that’s where Dr. Miz operates.”

In addition to achieving pain relieving results, minimally invasive SI joint fusion:

Uses smaller incisions

Reduces blood loss

Decreases operating room time

Minimizes tendon irritation

For more information, call Ingalls Care Connection at (708) 915-PAIN (7246).

Provided by Ingalls Health System