Sacroiliac pain after spinal fusion is a common consequence of spondylodesis surgery. In fact, sacroiliac symptoms are just the tip of the iceberg when it comes to the negative collateral effects of a fused spine, particularly in the lumbar region.
Spinal fusion surgery is utilized now more than ever before. Although originally invented to treat highly specific conditions of a very serious nature, fusion is now a common surgical approach for many spinal structural issues that are basically considered normal parts of aging. Fusion has become one of the most often used and abused surgical techniques in the developed world, although it is considered optional and contraindicated by objective medical standards in over 98% of recipients.
We have already spent our careers warning patients of the many risks of spinal fusion, but today, we will focus on highlighting the possible consequences to the sacroiliac joint and the resulting pain that often follows.
Types of Sacroiliac Pain After Spinal Fusion
We have observed a full diversity of sacroiliac joint problems commencing postoperatively after spinal fusion, including all of the following diagnoses:
We have seen accelerated degeneration in the sacroiliac joint, in similar ways to the accelerated degeneration found surrounding the fusion in lumbar spondylodesis patients.
Unilateral sacroiliac pain is more common, but about 35% of symptomatic patients eventually develop pain in both SI joints following fusion. Hip joint degeneration is also commonly present and symptomatic, often requiring hip replacement surgery within several years time.
Causes of SIJ Pain After Spinal Fusion
The sacroiliac joint connects the pelvic ilium to the sacral spine. When lumbar spinal fusion is performed, the most common locations include L4, L5 and S1, essentially enlarging the sacral spine to include the last 1 or 2 vertebral bones in the lumbar region.
The vertebrae are designed to be independent of one another, spaced by the existence of the intervertebral discs. This design allows the spine to mitigate stresses, reduce impact and curve in ways that better support the full range of movement that humans enjoy. When these discs are surgically removed and the bones fused, the form and function of the spine are inextricably changed for the worse. The spine can not longer bend or flex as organically engineered. Instead, stresses accumulate and are transferred through bone into other linked joints, such as the sacroiliac and hip.
In essence, lumbar loading will usually be dealt with in the lumbar spine. When the lumbar region is fused into the sacrum, the load and stress endured in the spine will cause this stress to be suffered by all the tissues that attach to the sacrum and pelvis. Additionally, fusion takes a toll on posture and normal anatomical alignments, which are also passed along to the sacroiliac joints, often with dire consequences.
Sacroiliac Pain After Spinal Fusion Guidance
Our best advice when it comes to spinal fusion is to avoid it, if at all possible. Do not allow any doctor to perform the technique simply to make their job easier, as is the case with almost all fusions performed in association with discectomy, laminectomy and other common spinal operations.
We understand that fusion does have its place and that some patients truly require it. It remains the only viable curative therapy for severe spondylolisthesis, extreme scoliosis, hyperlordosis and hyperkyphosis, as well as the only practical way of stabilizing the spine after serious traumatic injury or surgery that compromises the integrity of the vertebral column.
Unfortunately virtually everyone who searches for and reads this page will have already undergone spinal fusion. We wish we had the chance to discuss your options before you decided to enter into surgery. We have been writing to warn patients of the many risks and consequences of spinal fusion for close to 15 years now. You can find all of our articles on the topic by searching spinal fusion and spondylodesis using our site search function. If you are one of the few who still has options, we highly recommend you consider your future treatment very carefully, as fusion begets suffering and additional fusions in most cases and for most diagnoses.