The sacroiliac joint (SI joint) is the joint connecting the sacrum which is the lowest portion of the spine to the ilium which is the hip bone. Pain from the sacroiliac joint localizes to the upper buttock region and can also cause pain into the groin, thigh, calf, and foot.
Trauma is the most common cause of SI joint pain. Pregnancy can also lead to SI joint dysfunction as hormones produced during pregnancy cause a looseness of the ligamentous structures supporting the joint. Furthermore, patients that undergo lumbar fusions are at increased risk for developing SI joint pain due to the greater stress being put on this area.
The diagnosis of SI joint dysfunction relies mainly on the response to injection of steroid and anesthetic directly into the joint. Treatment options for SI joint dysfunction include medications (usually antiinflammatories and muscle relaxants), physical therapy, injections, radiofrequency ablation, and surgery. Surgery is indicated when nonsurgical options have failed to provide long lasting relief of pain.
A new minimally invasive procedure to fixate the SI joint is now available and our practice is the first to utilize this technique in Pennsylvania. The surgery involves a small 3-4 cm incision over the outer buttock area. Then 3–4 triangular titanium rods are placed across the SI joint to help stabilize it.
The procedure generally takes 1–2 hours and usually requires an overnight stay in the hospital. For the first 3–4 weeks after the procedure, patients are not to bear weight on the same side leg as the surgery. Patients may advance to partial weight bearing for the next 3–4 weeks.