Joint Fusion Freedom

Minimally invasive technique ends low back pain.

When Dana Caproon, 55, was 20 years old, his pelvis was fractured during an automobile accident in which the car he was in was T-boned on the passenger side where he sat. Dana, a California native, believes that accident was the start of many painful episodes he has since endured with his spine.
“Later in life, I had a ten-year competitive judo career, which didn’t do much to help my spine,” Dana admits. “And on my mom’s side, there’s a genetic predisposition for arthritis. So, with all the trauma to my body, in addition to the genetic thing, my back hadn’t been feeling very good the past few years.
“Recently, I experienced a lot of pain in my back. When I was at rest, it was a strong, deep aching, but when I was in motion, it turned into a sharp pain. Going from standing up to sitting down or sitting to standing up, any kind of motion actually, really aggravated the pain, and I was almost to the point of tears.

Photo by Fred Bellet.

Spinal fusion therapy has Dana practicing judo again.

“The pain kept me from most physical activity. It was difficult to get out of bed, and I couldn’t lift very much weight. Even going out to socialize was hard because I’d have to get up and sit down, and I was never comfortable anywhere. It became unpleasant to do pretty much anything. I felt like I was stuck at home. I couldn’t even think about judo.”
When Dana’s pain continued to worsen, he decided to seek help from a pain management specialist. He looked for physicians with expertise and decided to visit Sunil Panchal, MD, a board-certified interventional pain specialist. Dr. Panchal is president and medical director of National Institute of Pain, which has centers in Lutz and Tampa.
After an evaluation, Dr. Panchal discovered that most of Dana’s pain was coming from his sacroiliac (SI) joint, the joint that links the pelvis to the sacrum, the lowest part of the spine. Since he first saw him several years ago, Dr. Panchal has tried various pain management techniques to bring Dana relief from his pain.
“I had numerous radiofrequency ablations on my lower back, specifically my SI joint, and they were very effective for a few years, but my condition progressed,” Dana remembers. “I now have a neurostimulator in my spine, and that helped a lot after the denervation procedures stopped being effective. But lately, the neurostimulator has not been sufficient.”
The lack of response from the neurostimulator, which is an implanted device that interrupts pain signals delivered to the brain, prompted Dr. Panchal to recommend a minimally invasive yet more permanent solution for Dana’s back pain. The solution Dr. Panchal recommended was a fusion of the SI joint.

Proven Technique

Dr. Panchal performs this fusion procedure on one side of the spine at a time. After Dana agreed to go ahead with it, Dr. Panchal proceeded by performing the procedure on the right side of Dana’s spine.
“The procedure is a one-hour, minimally invasive surgery,” explains Dr. Panchal. “The incision is made on the side of the patient’s buttock and is less than two inches. The surgical instruments are passed through the incision, under x-ray guidance, to the precise area to fuse the SI joint.”
When performing SI joint fusions, Dr. Panchal goes across the joint to gain access to it. He also uses a technique that involves placing bone graft material into the joint to get a solid fusion. Studies have shown this technique has a 94 percent success rate two years after surgery and has the best documented results of all techniques available.

Jealous of Relief

Following his SI fusion, Dana reported significant pain relief on his right side. He is so pleased with the results that he is now contemplating having the same surgery on his left side, where he continues to have some lingering discomfort.
“My left side is jealous of my right side,” jokes Dana. “There’s a very noticeable difference. It’s almost like there are two different spines in my body. My right side has healed extremely well. There’s no significant loss of range of motion post-surgery as opposed to normal.”
Dr. Panchal generally waits at least three months before fusing the second side of a patient’s joint, in part because time sometimes deems a second surgery to be unnecessary.

“My left side is jealous of my right side. . . . It’s almost like there are two different spines in my body.” – Dana

“Some patients achieve so much pain relief from the first side that their posture and walking improve to the point the pain on the other side becomes less bothersome,” he informs. “These patients often decide not to have surgery on the second side because the pain improves enough on its own.”
Dana says he hopes that proves to be the case with him.
“Activities are still difficult for me to do because of the pain on my left side, but the pain in my right side is negligible,” he says. “On my left side, the pain varies from a five to nine on a scale of one to ten, but on my right side, the pain is only a two to four, maybe less, depending on what I do.”
Dana adds that he regrets waiting so long to have surgery on his joint.
“I tried to go a more conservative route to treat my back pain, with the radiofrequency nerve ablation and then the neurostimulator,” he states. “I just wish I would’ve done the fusion surgery sooner because I think it could’ve saved me years of pain.
“The SI fusion surgery Dr. Panchal performed on my right side was one hundred percent successful. I’m thoroughly pleased with my results.”

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    • National Institute of Pain

      We treat each patient individually, using the latest equipment and various innovative procedures to diagnose pain and determine your care needs. We then assemble the appropriate interdisciplinary team of health care professionals who can best... Read More

    • Sunil J. Panchal, MD

      Sunil J. Panchal, MD, is board certified by the American Board of Anesthesiology in interventional pain medicine. He earned his Bachelor’s degree in Biology from Rensselaer Polytechnic Institute in Troy, NY, and earned his medical degree from... Read More