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  • Bopharm11
    Participant
    Post count: 1

    Hi!! and thank you for providing such a great resource for us ( patients).
    I had a fusion at L/4-5 in 2018. Before the surgery , I was getting facet blocks at L4/5 ,L5-S1 and SI joint , which all seemed to help till pain was unbearable. I had a fusion at L-4-5. Soon after surgery pain returned and surgeon told me i needed L5-s1, yup, i figured… i waited and now its like i have a pinched nerve.. cant lay flat without severe pain ,cant put any weight on right leg , i have pain that extends down my buttock and into leg.
    I am going into sx friday for decompression fusion L5-s1.
    Surgeon wants to fuse my SI as well. I am really not sure about this part and think im going to decline the SI part. Not really getting clear diagnostic answers for this .. sometimes block works, SI joint looks arthritic on ct. any diagnostic test with PE hurts afterwards not during the palpation for SI.
    I think my pain is from L5-s1. Leg pain is groin, front of thigh , back of thigh into calf,
    I do have tear at l2-3 and it hurts, arthritic joint L3-4 , Another surgeon wanted to fuse L3-4.. ugh. Is the SI joint likely the cause of this pain? Buttock pain or any of the significant pain?
    I dont want to wake in same pain ?after surgery.
    Could previous L/4-5 be causing an issue if there was not a decompression, just fusion. Thank you!! Ljs

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    SI joints only rarely cause pain localized to the SI joint region. As a general rule, I would not have the SI joint fused along with your L5-S1 level.

    I would have a block of the L5-S1 level to see if the pain you are experiencing would temporarily diminish. If you obtain great temporary relief, I would avoid the SI fusion.

    See https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic/
    https://neckandback.com/treatments/diagnostic-vs-therapeutic-injections/ and
    https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections/

    Dr. Corenman

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