Sacroilliac Joint Pain & Fusion

Posted by Oh My Aching Back & Neck @jmweissler, Mon, Aug 19 12:33am

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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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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@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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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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