Donald Corenman, MD, DC
Post count: 8436

I am unclear as to the meaning of 85-90% union. Does this mean complete union or “you are almost there” type of union? This can make a big difference. Use of BMP with increased pain in my practice means a new MRI is warranted to look for the “BMPoma”.

You have not had a SNRB of the L5 root on the left yet. In my practice, that would be the next step along with an MRI. If the patient would get great relief, I would focus more on the L5 root than the SI joint. Again- if good relief (depending upon the MRI findings), I would consider removing the instrumentation and exploring the nerve root before considering fusion of the SI joint.

If the SNRB gave no relief or the MRI demonstrated no compression or adhesions of the L5 root, then I would consider a fusion of the SI joint.

Dr. Corenman