All Posts in Category: Lumbar Surgery

Sacroiliac Joint Pain [Updated 2024]

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There are many causes for low back pain that are treated here at Legacy. One common condition that can often be overlooked originates at the sacroiliac (SI) joints. They are located where the ilium of the pelvis meets the sacrum—the left and right sides of the sacrum.  Strong ligaments and muscles hold the SI joints in place and allow only a few millimeters of movement when the body bears weight or flexes forward. Arthritic and certain age-related degenerative disorders may gradually erode protective joint cartilage, which can subsequently lead to instability and pain that can mimic some of the symptoms of lumbar pathologies.

Understanding Sacroiliac (SI) Joint Dysfunction

The Role of the SI Joints

The sacroiliac joints play a crucial role in transferring weight and forces between the upper body and the legs. Strong ligaments and muscles support these joints, allowing limited movement. This movement is essential for activities such as walking and lifting. However, the SI joints are also susceptible to dysfunction, leading to lower back pain.

Causes Beyond Arthritis and Degeneration

While arthritis and degenerative disorders are common culprits of SI joint dysfunction, other factors can contribute to or exacerbate the condition:

  • Injury: A fall, car accident, or any impact that affects the lower back can injure the SI joints.
  • Pregnancy and Childbirth: The body releases hormones during pregnancy that allow ligaments to relax, potentially leading to altered joint function and pain.
  • Gait Issues: Abnormal walking patterns can place uneven pressure on the SI joints, leading to dysfunction.
  • Hypermobility or Hypomobility: Either too much or too little movement in the SI joints can cause pain.

Identifying SI Joint Dysfunction

Diagnostic Challenges

SI joint dysfunction can mimic other lumbar spine disorders, making diagnosis challenging. A comprehensive assessment is crucial, which may include:

  • Physical Examination: Specific maneuvers, such as the FABER (flexion, abduction, and external rotation) test, can indicate SI joint involvement.
  • Imaging Tests: While X-rays, MRI, and CT scans can help rule out other conditions, they may not always clearly identify SI joint dysfunction.
  • Diagnostic Injections: Injecting a local anesthetic into the SI joint is often the most definitive way to diagnose SI joint dysfunction.

Expanded Treatment Options

Conservative Approaches

  • Manual Therapy: Chiropractic adjustments or osteopathic manipulation can help alleviate pain by restoring proper alignment and function.
  • SI Joint Belts: These can provide additional support, especially during pregnancy or early stages of rehabilitation.

Advanced Treatments

  • Radiofrequency Ablation: This minimally invasive procedure can provide long-term pain relief by disabling the nerves that send pain signals from the SI joint.
  • SI Joint Fusion: In severe cases, surgically fusing the SI joint may be considered to stabilize the joint and reduce pain.

Lifestyle and Home Remedies

  • Exercise: Tailored exercises to strengthen the core, pelvic floor, and buttocks can improve joint stability.
  • Posture: Educating patients on proper posture and ergonomics can prevent further strain on the SI joints.

Recent Advancements

Recent research has focused on improving diagnostic techniques and treatment outcomes for SI joint dysfunction. Innovations in minimally invasive surgery, such as robotic-assisted SI joint fusion, have shown promising results, offering greater precision and potentially faster recovery times.

Conclusion

Understanding the complexities of SI joint dysfunction is crucial for effective treatment and management. By considering a wide range of causes, employing thorough diagnostic strategies, and utilizing both conservative and advanced treatment options, healthcare providers can offer relief to those suffering from this condition. Staying informed about the latest advancements in treatment can further enhance patient care.

Adding these details will provide your readers with a comprehensive understanding of SI joint dysfunction, its impact, and the multifaceted approaches to treatment available at Legacy. This expansion not only enriches your original content but also positions your blog as a valuable resource for those seeking to understand and find relief from low back pain.

 

 

 

Sources:

https://www.spineuniverse.com/conditions/sacroiliac-joint-pain/sacroiliac-joint-animation

https://www.medindia.net/patients/patientinfo/sacroiliac-joint-dysfunction.htm

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30 Year Anniversary of Dr. Schlesinger’s Publication of a Landmark Article!

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It is the 30 year anniversary of the publication by Dr. Scott Schlesinger of the landmark article on the technique of minimally invasive far lateral disectomy approach.   The publication was the outcome of a one year fellowship in minimally invasive neurosurgery at Le Centre Hospitalier Universitaire Vaudois (CHUV)  in Lausanne Switzerland.   This detailed study of the microanatomy of this unique approach along with the technique was published in ACTA Neurosurgica and subsequently presented to the European  and American National Neurosurgical societies.

The operations main benefit is it spares the removal of the entire spine joint on the side of surgery (facet joint) thus minimizing the iatrogenic risk of future spinal instability and therefore lowers the chances of needing a lumbar fusion procedure.  Therefore the standard alternative to this MIS approach involves doing a simultaneous lumbar fusion with instrumentation or in many cases the delayed need for such.   The far lateral approach to ELLDH has been used by the authors in thousands of cases over the last 30 years both in Switzerland and in the United States with excellent outcomes.  Also the anatomy learned in this research has subsequently been used by Dr. Scott Schlesinger to develop the SLIF MIS fusion surgery.  This uses a far lateral approach for a “screw-less” standalone MIS decompression and interbody fusion.

Learn more about the unique offerings at Legacy Neuro of the SLIF and other MIS procedures including the ELLDH surgical option.

Click below to view the original article and to view several videos regarding this approach!

Microsurgical Anatomy and Operative Technique for Extreme Lateral Lumbar Disc Herniations

Video 1

Video 2

Video 3

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Screwless | Lumbar Interbody Fusion (S-LIF)

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THE WORLD’S LEAST INVASIVE LUMBAR FUSION SURGERY: the S-LIF, Developed by and available exclusively at Legacy Spine & Neurological Specialists.

Sciatic nerve pain can be disruptive. Constant pain and numbness due to a compressed nerve with spine instability can hinder your daily life. So can invasive spinal surgery and the recovery time that comes along with it. But not anymore, thanks to S-LIF technology.

The S-LIF is the least invasive option for lumbar fusion surgery available anywhere in the world. When Dr. Schlesinger developed the MIG-LIF procedure in 2015, it was the least invasive fusion option also done through a keyhole outpatient surgery. While this was a great breakthrough at the time in MIS spine surgery, Dr. Schlesinger felt that the next logical step was to achieve the same outcome with even less surgery.

Through application of his microsurgical skills and experience in delicate surgery on aneurysms and tumors of the brain, this next step became a reality. The S-LIF is the least invasive option in the world for many patients with the need for a decompression and fusion of the lumbar spine. It is not for all patients as some still require more invasive surgery. But for those that are candidates for MIS surgery, this is an outstanding option.

The S-LIF procedure is performed by our two talented neurosurgeons Scott Schlesinger, MD, and Dominic Maggio, MD. Scott Schlesinger, MD has practiced neurosurgery since 1992. He trained in Neurosurgery at UT Southwestern with a fellowship in Lausanne, Switzerland. He has received multiple awards and multiple recognitions as the Best Neurosurgeon in the state. Dr. Schlesinger is the founder of Legacy Spine and Neurological Specialists and the developer of the S-LIF procedure.

Dominic Maggio, MD joined the Legacy team in July 2021. He is an excellent surgeon who specializes in the S-LIF procedure as well as a wide variety of other spinal surgery. He trained at the University of Virginia-National Institutes of Health neurosurgery program and received multiple awards for his research and clinical skills. He subsequently did a fellowship at Ohio State University in complex and minimally invasive spine surgery techniques.

To find out if the S-LIF is an option for you or for more information call us today at 501-661-0077 or email contactus@wordpress-967348-3758640.cloudwaysapps.com. We look forward to the opportunity to serve you!

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