SACROILIAC SURGERY

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Bilateral Fixation of SI Joints with Cannulated Screws Percutaneously

 

Sacroiliac (SI) Joint Pathology Case Study Series

Bilateral Fixation of SI Joints with Cannulated Screws Percutaneously

David Weiss, MD, Vicki Sims, PT, CHT

Gainesville, GA

Patient Record

The patient is a 69-year old female who was referred to Gainesville Physical Therapy in August 2010 for conservative treatment of Sacroiliac Joint Dysfunction, which did not resolve her symptoms.

History LBP for 6 years after falling on buttocks
Symptoms Pain moderate to severe 80% of the time.
Limitations Could walk for only short distance Sustained positions
Tests
  • MRI
  • EMG: Negative for piriformis syndrome and lumbar radiculopathy
Prior Treatment She was treated with a conservative program of physical therapy for scoliosis stabilization, which included mobilizing the joint into correct position, postural taping, SI belt, and pelvic stabilization exercises.
Co-existing Problems Bulging disc at L4-5
Surgical Intervention November 16, 2010
6 Months Post-op
  • Functional Level:
    • Gardening
    • Kayaking
    • Daily Chores
    • Shopping
    • House Cleaning
    • Walking 2.5 miles 5 days per week
    • Yoga twice a week
  • Pain Level:
    • No symptoms


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Bilateral Fixation/Fusion of SI Joints with iFuse Implants on the Right and Cannulated Screws Percutaneously on the Left

 

Sacroiliac (SI) Joint Pathology Case Study Series

Bilateral Fixation/Fusion of SI Joints with iFuse Implants on the Right and Cannulated Screws Percutaneously on the Left

David Weiss, MD, Vicki Sims, PT, CHT

Gainesville, GA

Patient Record

The patient is a 29-year old female who was referred to Gainesville Physical Therapy in April 2011 for conservative treatment of Sacroiliac Joint Dysfunction, which did not resolve her symptoms.

History LBP for 6 years after heavy, frequent lifting
Symptoms No pain reported in the morning. Pain would begin around noon on the days that she worked. The symptoms were at their worst in the evenings. The pain is described as a strong ache in the right buttock and sharp pain (pain level 8-10) over the right SI joint and sacrum during transitional movement and turning over in bed.
Limitations Able to work, but not able to do exercise or participate in social activities after work
Tests
  • MRI: Negative
  • EMG: Negative
  • SI Injection: Positive on the right
Prior Treatment Multiple physical therapy sessions, chiropractic care, 10 sessions of prolotherapy, pain medication, SI injection, lateral branch neurotomy, medial branch block L4-5
Co-existing Problems None
Surgical Intervention June 28, 2011
5 Months Post-op
  • Functional Level:
    • None
  • Pain Level:
    • None


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Left Side Fixation of SI Joints with Cannulated Screws Percutaneously

Sacroiliac Joint (SI Joint) Pathology Case Study Series

Left Side Fixation of SI Joints with Cannulated Screws Percutaneously

David Weiss, MD, Vicki Sims, PT, CHT

Gainesville, GA

Patient Record

The patient is a 66-year old female who was referred to Gainesville Physical Therapy for conservative treatment of Sacroiliac Joint Dysfunction, which did not resolve her symptoms. She had an SI injection, multiple sessions of physical therapy and Chiropractic care with little to no success.

History 30-year history of LBP. She had an SI injection, multiple sessions or PT and Chiropractic care with success. Patient participated in a conservative PT program for SI stabilization without success.
Symptoms Constant left hip pain, radiating down posterior aspect of the left leg. Left SI pain along with inability to sit, drive, climb stairs and wear heels. Sustained positions increased pain. Pain was a constant 7-8
Limitations None
Tests
  • MRI
Prior Treatment None
Co-existing Problems Bulging disc L3-4, L4-5, L5-S1 (severe left foramina stenosis at L5-S1 with compression of left L5 exiting nerve), facet radiculopathy at L3-4, L4-5, L5-S1
Surgical Intervention November 9, 2010
6 Months Post-op
  • Functional Level:
    • Back to Normal
  • Pain Level:
    • Intermittent minor pain in left hip with certain activities otherwise pain free

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