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Archive July 2020 XXI, No. 7

Solving Sacroiliac Joint Pain

Surgery is more effective than ever in helping patients overcome a frustrating and debilitating condition.

Adam Taylor


ADDED STABILITY An implant employing triangular titanium cages promotes immediate fixation to bone, leading to quicker immobilization of sacroiliac joints.

Patients with sacroiliitis often arrive at a physician's office at the end of the road. They're distraught and emotionally drained after suffering with lower back pain for years. They often feel as if they've run out of options after having sought help from multiple doctors without receiving a proper diagnosis. Thankfully, better evaluations and testing are allowing more patients to take advantage of underused implant systems that can end the pain they feel every time they sit, stand, sleep or simply try to get through their day.

The "hidden cause"

Many physicians and patients don't know that 15% to 20% of back pain is related to sacroiliac disorder, according to Jordi Kellogg, MD, a neurosurgeon with Kellogg Brain & Spine who operates in outpatient surgery centers in Portland, Ore. When one or both sacroiliac joints, located at the intersection of the lower spine and the pelvis, are inflamed, patients feel pain in the lower back and buttocks that often radiates down one or both legs. That's why sacroiliitis is often mistaken for sciatica, and often goes untreated for years, says Dr. Kellogg.

The condition also mimics symptoms of herniation and spondylosis and is often misdiagnosed as one of those conditions.

Properly working sacroiliac joints stabilize and support the body and absorb much of the impact from walking, lifting and other activities. Sacroiliac dysfunction, essentially, is when the joints start to shift. The unwanted articulation is caused by all kinds of trauma, including multiple or traumatic pregnancies, motor vehicle accidents and falls, says Omar Gonzalez, a physician's assistant at Kellogg Brain & Spine. Sacroiliitis can also be a sequela of previous spine fusions, which increase the load on the sacroiliac joints. The symptoms often appear years after the fusions took place.

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