12/16/2023 0 Comments Fusion 360 jointsHowever instrumentation remained limited to threaded screws and cages that rely on autologous bone graft. Reports of minimally invasive surgical (MIS) techniques to address the SI joint began appearing in 2008. Moreover, patients were kept non-weight bearing for several months postoperatively. Though casting and bracing were no longer required, perioperative morbidity was not trivial with relatively large incisions, significant bone harvesting, and lengthy hospital stays. In the mid 1980s, reports of internal fixation using metal plates and screws began to appear. Studies that followed continued non-instrumented approaches to achieve arthrodesis and most required either long periods of immobilization or casting and bracing for a substantial period of time. Smith-Petersen and Rogers first reported SI joint arthrodesis in 1921. For patients who do not experience adequate resolution of symptoms, surgical arthrodesis is an option. steroid) joint injections and, in more severe cases, radiofrequency ablation. The treatment regimen often includes medication optimization, activity modification, physical therapy, therapeutic (i.e. Diagnosis of SI joint disorders in the absence of acute trauma is made with a careful amalgamation of patient history, clinical exam, provocative physical tests, imaging, and diagnostic joint injections. Up to 75% of post-lumbar fusion patients develop significant radiographic SI joint degeneration after 5 years. Two studies report prevalence rates of 40% and 43%. SI joint pain after lumbar fusion is not uncommon. Disorders of the SI joint may be the result of trauma, pregnancy, inflammatory arthritis, osteoarthritis or degeneration of the joint either de novo or post lumbar spinal fusion. Several studies report up to 30% prevalence of SI joint disorders in patients diagnosed with low back pain. The number of patients under-diagnosed and/or misdiagnosed is not inconsequential. Furthermore, SI joint abnormalities may not be visible on imaging studies ordered to evaluate the lumbar spine. Diagnosing the SI joint as the primary pain generator is difficult as patients often present with a combination of low back, groin, gluteal, and/or leg pain with signs mimicking radicular or discogenic distributions. Sacroiliac (SI) joint pain can be debilitating to patients, yet is an often-overlooked source of low back pain.
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