SI Fusion Targets Pain In Pelvic Joints

Minimally invasive procedure terminates chronic, agonizing low back pain.

Since her SI fusion, Mary is back to walking and enjoying life.

During her lengthy working career, Mary Maloof dabbled in multiple disciplines, including fashion design. That experience has proved useful in her current volunteer efforts.

“One of my main projects is teaching African refugee women to sew and make jewelry,” Mary elaborates. “We have a website where we sell the products the women make.”

At 83, Mary remains quite active. In recent years, however, she has been slowed a bit by chronic, agonizing low back pain.

“The pain became pretty unbearable, an eight to 10 on a scale of one to 10,” she confirms. “It was very debilitating because it kept me from exercising and walking. It even hurt if I was just sitting down or getting up from a sitting position.

“I tried physical therapy, but that just aggravated it. I then got injections into my lower spine. They helped for a couple of months, but then I had to repeat them. I also visited several pain management practitioners, but nothing they did helped.

“Finally, I went to see Dr. Brown, whom I knew because she used to live in my building.”

Lora L. Brown, MD, is a fellowship-trained interventional pain specialist at TruWell Health in St. Petersburg. After conducting a thorough examination, Dr. Brown diagnosed Mary’s issue as sacroiliac (SI) joint pain.

There are two SI joints on both sides of the pelvis that act as a shock-absorber for the upper body. They link the iliac bones, which are the upper wings of the pelvis, to the sacrum, the shield-shaped bone at the base of the spine.

“SI joint pain is very common in people older than 60,” Dr. Brown asserts. “It is responsible for about one-third of all chronic back pain. SI joint pain is typically felt at or just below the beltline. It can be unilateral, felt on one side only, or bilateral, felt on both sides. The pain can be sharp, dull or aching.”

The SI joints are not designed to move, except when women are in labor, Dr. Brown reports. The hormones of pregnancy cause the supporting ligaments to relax, allowing the joint to open and the birth canal to widen so the baby can be born.

“But injury and arthritis can also trigger those ligaments to relax, which causes micromovement of the joint,” the doctor observes. “This abnormal movement results in arthritis of the joint surfaces and chronic pain. The reason Ms. Maloof’s pain never went away was because she had not been
properly diagnosed.

“We performed a physical exam and diagnostic injections to make sure her pain was coming from her SI joints. Once that was established, we treated her using a safe, minimally invasive procedure called SI fusion.”

An SI fusion can be performed in less than an hour, during which time the patient is under conscious sedation, or twilight sleep. The procedure begins with the physician making a tiny incision in the buttocks, through which the physician works.

“We place a small bone implant into the joint,” Dr. Brown explains. “We then pack the implant in a stem cell-type material that enables the bony surfaces of the joint to fuse. Once the joint fuses, pain is eliminated and function is restored.”

It takes about 12 weeks for the bones to fuse, but the procedure “permanently” fixes the problem, according to Dr. Brown.

Unlike a spinal fusion where a normally mobile joint is fused, the SI fusion fuses a joint that is meant to be fixed or immobile. There are no long-term negative consequences to SI fusion.

Dr. Brown performed Mary’s SI fusion in early June. Mary was amazed by how well she felt afterward.

“As soon as the anesthesia wore off and I woke up, I realized that the pain was gone, and it’s been gone ever since,” Mary enthuses. “My pain level is now zero. I feel 100 percent better. I’m back to walking, doing Pilates and enjoying life again.”

Mary credits her turnaround to her treating physician.

“I love Dr. Brown; she’s wonderful,” Mary raves. “She’s extremely knowledgeable and very empathetic. When other treatments didn’t work she suggested the fusion, and that took care of all my back problems. I highly recommend her and TruWell Health.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb
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    • TruWell Health

      TruWell Health is located in a professional medical building in downtown St. Petersburg. There is free parking and free valet service. Our office is elegant, warm, comfortable and modern, and we utilize the latest technology... Read More

    • Lora L. Brown, MD

      Lora L. Brown, MD, is certified by the American Board of Anesthesiology and American Board of Pain Medicine. She is also a fellow of the American Board of Interventional Pain Physicians. Dr. Brown earned her bachelor’s degree cum laude from th... Read More