Failed SI Joint Fusion

///Failed SI Joint Fusion
Failed SI Joint Fusion
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  • Avatarstaciela
    Participant
    Post count: 2

    Hi Dr.Corneman.

    I have had low back pain for years. I have had to have both hip labrums replaced, which took care of some of the pain. However, my left side pain continued to get worse. After many tests (CTs, MRIs, xrays, test to also see if radiofrequency ablation would work and it had a failed result), my left SI joint was fused. The fusion worked great for the first 5-6 months after which the pain returned. I am 13 months post fusion and the diagnosis is a failed fusion as the MRIs have shown “no evidence of bony fusion”. The pain is worse than before the fusion and is getting worse. I have had to resign my teaching position and I have no quality of life. I can not sit in a chair or stand for more than a few minutes before the SI joint starts to get painful.
    Over the past month, I have had 2 coudal injections with no relief. My dr (pain specialist in Fruita, CO) is telling me my last “Hail Mary” is to have a spinal cord stimulator implanted.
    While his office is working on insurance approval, I was referred to you for a 2nd opinion. Is there anything you could do to help a failed SI joint fusion other than a SPS?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6907

    Generally, spinal cord stimulators are not too effective for sacroiliac pain. They are more effective for nerve pain (leg pain). I hope you have had a CT scan as an MRI is not a great test to indicate fusion status. Depending upon the technique used to try and obtain fusion of the SI joint, you might be a candidate for a fusion revision.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Avatarstaciela
    Participant
    Post count: 2

    Thank you so much for your reply. I have had a CT scan and it also said, “no evidence of bony fusion”. Do you perform SI fusion revisions?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6907

    I have performed SI fusion revisions but it depends upon the original technique used and failure mode of the pseudoarthrosis.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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