Sacroilliac Joint Pain & Fusion

Posted by Oh My Aching Back & Neck @jmweissler, Aug 19, 2019

Hi. I am a 62 yo male. I fractured my L5/S1 which resulted in Spondylolisthesis in 1998. Had lumbar fusion. Suffered in severe pain until 2008 at which time I had exploratory surgery. Ends up I didn't fuse at all due to have a severe case of Osteoporosis. Since then I have had 11 lumbar fusions (PLIF, ALIF, XLIF) from T12 to S1. In addition, in late 2018, My cervical spine went & I had anterior cervical discectomy and fusion (ACDF) from C4 to C7. Now it seems that my my SI joints are shot as they are bearing the weight of my upper body that my spine was supposed to do. I have had 4 SI joint ESI's & RF ablation with no relief. It seems as if I am heading for bilateral SI Joint fusion. My question is, what is the post-op & recovery like? I am very limited in my pain med usage due to prior opioid usage. How long before the other side can be done? They won't do both at the same time. Anyone ever have a hip replaced at the same time? Thanks in advance for your responses & I stand with you all as Pain Warriors! 🙂

Hello @jmweissler. I'd like to invite @mdmo and @jrbuff who specifically talked about having or considering a SI joint fusion. Here is another discussion you also may be interested in as well – Spinal fusion at L4 to L5 due to spondylolisthesis https://connect.mayoclinic.org/discussion/spinal-fusion-at-l-4-l5-due-to-spondylolisthesis/.

@jmweissler, if you are comfortable sharing, you have mentioned many fusion surgeries, other than your osteoporosis playing a role, how has your recovery been from your previous surgeries?

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@JustinMcClanahan

Hello @jmweissler. I'd like to invite @mdmo and @jrbuff who specifically talked about having or considering a SI joint fusion. Here is another discussion you also may be interested in as well – Spinal fusion at L4 to L5 due to spondylolisthesis https://connect.mayoclinic.org/discussion/spinal-fusion-at-l-4-l5-due-to-spondylolisthesis/.

@jmweissler, if you are comfortable sharing, you have mentioned many fusion surgeries, other than your osteoporosis playing a role, how has your recovery been from your previous surgeries?

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It's a tough go.Painful. Unfortunately, I never really healed from the prior surgery before the next fusion was done. At the moment, I still have terrible pain in the L5-S1 area as well as moderate pain in my neck. I am hoping that the SI Joint fusion relieves at least some of the pain. I am keeping Tylenol in business. I am very interested to learn about open bilateral SI Joint fusion.

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Sorry about that. I am scheduled to have open bilateral SIJ fusion in a few weeks. I was wondering if anyone has had this surgery. If so, please let me know what the surgery, post-op & recovery was like. I am really nervous as my surgeon (@ HSS) has told me it will be worse than any other of my 11 spine fusions as he is doing 2 different areas. HELP. 🙂

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Hi. I am a 62-year-old male living on Long Island, NY. I have currently been having in pain in my lower lumbar, groin & hips for months and it has escalated to the point I can hardly walk my dog. Had an X ray taken and sent to my doc. He said my Sacroiliac (SI) Joints are no good. I had 3 ESI’s & then RFA, none of which worked at all. Followed by another series of 3 more ESI’s. These did not help at all. My surgeon called me in for a chat to discuss surgery. I have finally scheduled Bilateral SI Joint Fusion using the Posterior Midline Approach. This is an open surgery, evidently this is a seldom used surgery as Minimally Invasive Surgery is the procedure of choice. If anyone has had SI Joint surgery, please let me know about the surgery, postop, rehab & if it helped.
My History – I suffered a fracture & spondylolisthesis @ L5/S1 in a trauma in 1998 & had fusion in 1999. After the surgery the pain never went away & at times was worse. I started pain management in 2001. They gave me different meds that didn't work until I was on the maximum dose of both Oxycontin & Oxycodone. When that wasn't helping, they added Fentanyl patches until I was maxed out on that. Lived like that until 2008. In 2006 I had a spinal cord stimulator (SCS) implanted. I lived this way until 2008 when my family decided I couldn't live like this anymore. Went to The Hospital for Special Surgery (HSS) in June 2008. They did an exploratory. They discovered that the fusion failed, even though numerous surgeons told me all was fine. My exploratory turned into a 6-hour PLIF. Ten days later I had ALIF. They also removed the SCS. It was discovered that I suffer from a severe case of osteoporosis (-3.2). Rehab was tough. Felt better but not great. Was still on all the meds. I retired from my job on disability as I could no longer work. In April 2011, I started having severe pain. Back to HSS. An MRI was done and the diagnosis was a fracture @ L4/L5. Back in the OR & another fusion. In November 2011, the pain was worse. It was discovered that the fusion failed so I had a revision. Fifteen days later I experienced the worst pain so far. It was a cyst @ L4/L5. Emergency surgery. In January 2013, it was discovered the fusion @ L4/L5 failed again. Another revision. Did relatively well but still lots of pain until November 2014 when L3/L4 went. Had a good 2015 but in February 2016 L1/L2/L3 went. They fused T12 to L3. In December 2016, guess what, L1/L2 failed and another revision. Moving on to September 2018 when C3 to C7 went. Had 4 level Anterior Cervical Discectomy (ACDF). In addition, I have had 2 heart attacks and a mini stroke which is why I need to be able to walk every day. I have a Service Dog, Bentley, to help pick up the numerous things I drop (due to cervical fractures I have neuropathy), retrieve things and the best part, he keeps me smiling.
Thanks. 😊
PS – I got off all of meds at the end 2017 when I fell & broke my nose.

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Hello @jmweissler. You may notice I brought your updated post back to your original post so that when members join the discussion, they are in the same discussion. That is a lot of surgeries @jmweissler, is your provider confident that proceeding with the SI joint fusion will help with the pain as well as be a long-term solution? I'd like to invite a few more members who have had issues with SI Joints, @gldnrtrvrlvr and @rhondas.

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Hi Justin. Thanks for re-posting. It is a lot of surgeries. My surgeon is a spinal disorder surgeon @ The Hospital for Special Surgery. He has done all the fusions with the exception of the first 1. He is very confident that this is the correct way to go. "Fusing vertebrae together alters the spine's flexibility, which can place more stress on the SI joint." per The Mayo Clinic.Based on the X-Rays & CT, the SI Joints are torn so there is too much movement. My son, a PS resident @ The Mayo says they do a lot of SI Joint fusions but I think he is talking about the MIS procedure not open surgery. Of all the people in these pages, I can't believe no one has had this procedure. Again, I appreciate your help. 🙂

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I'm having this done thurs morning. Just wondering how it went for you. This will be my 4th back surgery. My SI's feel like bone-on-bone. A lot of pain. Did you need a wheelchair? How long was your surgery? Hope it went well for you and you got some relief.

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SI Joint pain after fusion

I’m having pain in my hip area, mostly left side but it has spread across. I was given muscle relaxers, they are hoping it’s a pulled muscle but after two weeks it’s not improved very much. I’m having trouble standing up and sitting. And walking. I have to call the surgeon’s office, but has anyone gone through this after lumbar fusion? It’s been 3 months, I was feeling so much better but this has really upset me, all that I’ve gone through only to have pain lower down. I’m afraid it’s my SI joints; the other doctors I saw before this surgery told me they thought that was causing my pain. And my surgeon told me he couldn’t promise this would be my last surgery. Has anyone dealt with this, and what was your solution? Thank you!

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@ga29

SI Joint pain after fusion

I’m having pain in my hip area, mostly left side but it has spread across. I was given muscle relaxers, they are hoping it’s a pulled muscle but after two weeks it’s not improved very much. I’m having trouble standing up and sitting. And walking. I have to call the surgeon’s office, but has anyone gone through this after lumbar fusion? It’s been 3 months, I was feeling so much better but this has really upset me, all that I’ve gone through only to have pain lower down. I’m afraid it’s my SI joints; the other doctors I saw before this surgery told me they thought that was causing my pain. And my surgeon told me he couldn’t promise this would be my last surgery. Has anyone dealt with this, and what was your solution? Thank you!

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@ga29 I found this response from @jenniferhunter regarding her friend's situation in a discussion that you might also find helpful if you haven't stumbled across it yet. She may have additional information she can provide to help.

Sacroiliac Joint Pain and My Introduction:
https://connect.mayoclinic.org/discussion/sacroiliac-joint-pain-and-my-introduction/?pg=1#comment-208657
Have you heard about myofascial release therapy? (This was mentioned as a potential way to mitigate pain before considering surgery my members in the discussion above.)

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@ga29

SI Joint pain after fusion

I’m having pain in my hip area, mostly left side but it has spread across. I was given muscle relaxers, they are hoping it’s a pulled muscle but after two weeks it’s not improved very much. I’m having trouble standing up and sitting. And walking. I have to call the surgeon’s office, but has anyone gone through this after lumbar fusion? It’s been 3 months, I was feeling so much better but this has really upset me, all that I’ve gone through only to have pain lower down. I’m afraid it’s my SI joints; the other doctors I saw before this surgery told me they thought that was causing my pain. And my surgeon told me he couldn’t promise this would be my last surgery. Has anyone dealt with this, and what was your solution? Thank you!

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@ga29 I'm sorry to hear that you are in so much pain. You'll notice I moved your question to an existing discussion so you could connect with members like @jmweissler in a central location.

May I ask what next steps are?

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@amandajro

@ga29 I found this response from @jenniferhunter regarding her friend's situation in a discussion that you might also find helpful if you haven't stumbled across it yet. She may have additional information she can provide to help.

Sacroiliac Joint Pain and My Introduction:
https://connect.mayoclinic.org/discussion/sacroiliac-joint-pain-and-my-introduction/?pg=1#comment-208657
Have you heard about myofascial release therapy? (This was mentioned as a potential way to mitigate pain before considering surgery my members in the discussion above.)

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Thank you, I will look into this.
I have not done anything yet, saw my pain mgmt. doctor today who advised me to continue with rest, heat and ice regimen along with muscle relaxers until I discuss with the surgery team. I think he feels it is the SI joint too. He was not in favor of my fusion surgery, but I was doing well in my recovery until this happened.
I am wondering, if my waiting is doing more harm? I’m not due to meet for my PT consultation until the end of May, my surgeon had ordered it before this happened.

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@ga29

SI Joint pain after fusion

I’m having pain in my hip area, mostly left side but it has spread across. I was given muscle relaxers, they are hoping it’s a pulled muscle but after two weeks it’s not improved very much. I’m having trouble standing up and sitting. And walking. I have to call the surgeon’s office, but has anyone gone through this after lumbar fusion? It’s been 3 months, I was feeling so much better but this has really upset me, all that I’ve gone through only to have pain lower down. I’m afraid it’s my SI joints; the other doctors I saw before this surgery told me they thought that was causing my pain. And my surgeon told me he couldn’t promise this would be my last surgery. Has anyone dealt with this, and what was your solution? Thank you!

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Hi. I had open sacropelvic fusion in Oct. 2019. This was my 17 th fusion over 12 surgeries. SI joint pain can come from many sources. Was your surgery Minimally Invasive or Open. Do U have instrumentation? Healing takes a year at least. I still have si joint pain & expect that it will never go away but it is much better than before the surgery.

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