Clinical Summary

Who Can Have Sacroiliac (SI) Joint Fusion?

The iFuse Implant SystemTM procedure is suitable for treating Sacroiliac (SI) Joint-related pathologies and dysfunction due to a variety of causes. These may include injuries or chronic conditions. The following patients have graciously given permission to present their personal experiences regarding Sacroiliac (SI) joint disfunction, subsequent surgery using the iFuse System, and ongoing results of this treatment.

Patient with traumatic injury

This 45 year old truck driver developed low back pain when he fell off his truck. The source of his low back pain was found to be his left Sacroiliac (SI) Joint.

He was in extreme pain before he underwent a successful Sacroiliac (SI) Joint Fusion procedure where his surgeon placed three fusion implants across his Sacroiliac (SI) Joint. These show up as white bars in the x-ray on the left. At his 3-month follow-up he had relief and was free of Sacroiliac (SI) Joint dysfunction.

Patient with pregnancy-related chronic back pain

This 36 year old x-ray-technician suffered from low back pain for seven years following her pregnancy and a difficult delivery. She had severe Sacroiliac (SI) Joint dysfunction before she had an Sacroiliac (SI) Joint Fusion procedure where three fusion implants were placed across her joint. The patient experienced dramatic reduction of her Sacroiliac (SI) Joint symptoms following surgery.

Patient with job-related repetitive stress

This 57 year old man complained of low back pain for several years. In his job, he was required to perform repetitive bending and twisting. He experienced short-term relief after having a CT guided injection to his Sacroiliac (SI) Joint.

His symptoms decreased significantly after his Sacroiliac (SI) Joint Fusion procedure. The X-ray shows where his fusion implants were placed.

Other Conditions and Sacroiliac (SI) Joint Fusion

The Sacroiliac (SI) Joint Fusion procedure can be safely used even when a person has previously had other orthopedic surgeries and implants. As mentioned earlier, Sacroiliac (SI) Joint problems may coexist with lumbar spine or hip conditions. In some cases, Sacroiliac (SI) Joint dysfunction may appear after lumbar spine surgery as well as hip replacements. In order to avoid unnecessary repeat surgery at these sites, it is important to get accurate diagnosis that identifies the source of patient symptoms.

Patients with prior surgical procedures:

Patient with previous Spinal Condition

This 54-year old emergency room doctor previously had successful lumbar spine surgery for low back pain.
Approximately five years later, she started experiencing more low back pain and was eventually unable to work. This time her diagnosis was Sacroiliac (SI) Joint dysfunction. She had a successful Sacroiliac (SI) Joint Fusion procedure and was back at work after 11 weeks.

Sacroiliac (SI) Joint Fusion after both Lumbar and Hip Surgeries

This 64 year old woman previously had successful total hip replacement and lumbar spine surgery The x-rays below left show her implants from these procedures.

She developed Sacroiliac (SI) Joint dysfunction several years later, and underwent Sacroiliac (SI) Joint Fusion resolving her symptoms. The x-ray on the right show the fusion implants.

Sacroiliac (SI) Joint Fusion after Hip Replacement

This 68 year old man was treated for low back pain for both lumbar facet and Sacroiliac (SI) Joint dysfunction after a total hip replacement. Because of his severe symptoms, Sacroiliac (SI) Joint Fusion was recommended for him and he had four fusion implants placed in across his Sacroiliac (SI) Joint.

After his procedure his symptoms decreased significantly within 3 months. He continued to improve and one year after his Sacroiliac (SI) Joint Fusion procedure he was symptom-free and had a stable healing response.

Sacroiliac (SI) Joint Fusion and Other Conditions

In some cases, a person may require other surgeries after having an Sacroiliac (SI) Joint Fusion procedure. The iFuse Implants will not affect their ability to have such surgeries. For instance, someone who has had a successful Sacroiliac (SI) Joint Fusion procedure may later develop lumbar spine problems, with pain due to a different source from the Sacroiliac (SI) Joint. These can be treated appropriately.

The x-ray on the left shows two iFuse Implants in place. The patient developed lumbar symptoms 10 months after the procedure. These were addressed with successful spinal procedure. The x-rays on the right show the spinal implants after her lumbar fusion.

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An Advanced Approach to Surgical Management of SI Joint Dysfunction
Up to 25% of all low back pain is SI Joint in origin – but the diagnosis of SI Joint disease is frequently overlooked. (Cohen, et al.)
It is common to link low back pain with protruding disc even when neurological signs are absent. (Weksler, et al.)
It is common for pain from SI Joint dysfunction to mimic discogenic or radicular low back pain. (Weksler, et al.)
Many patients go on to receive lumbar fusion instead of SI Joint fusion – so SI Joint disease should be strongly considered in differential diagnosis of low back pain. (Weksler, et al.)
Now there is an approach to surgical management of SI Joint dysfunction that’s easier and less invasive than traditional open surgery.
The iFuse Implant System consists of porous plasma spray coated implants, surgically inserted across the SI Joint to create fixation leading to fusion—from the inside.
The iFuse creates a biomechanically rigorous fixation/fusion system, designed to support reliable fixation/fusion and acute weight bearing capacity.
With the iFuse Implant System, there is no need for BMP in conjunction with autologous bone graft or additional pedicle screws, rods or hollow modular anchorage screws or cannulated compression screws or threaded cages within the joint or fracture fixation screws.
iFuse benefits:
The iFuse Implant System is designed to be the sacroiliac joint fusion/fixation method of choice for spine surgeons.
iFuse is a minimally invasive surgical solution to replace open surgical SI Joint fusion.
With iFuse there's minimal incision size, minimal soft tissue stripping, minimal tendon irritation and reduced risk of infection.
iFuse is a simplified minimally invasive surgical procedure.
Just drill, broach, insert Implants and close.
iFuse has a simple technique which reduces OR time to less than 1 hour.
iFuse has 3X shear and 7X bending strength compared with screws.
iFuse has improved patient perception of stability post-implant.
The incidence of SI joint degeneration in patients was 75% at 5 years post-fusion, which was significantly higher than in the non-fusion group, 38.2%. (Ha, et al.)
Among patients with one-segment fusion, 91% developed SI joint degeneration. (Ha, et al.)
Regardless of whether the fusion includes the sacrum, the SI joint is influenced by increased mechanical stress arising from lumbar/lumbosacral fusion. (Ha, et al.)
Posterolateral lumbar/lumbosacral fusion can be a cause of SIJ degeneration. (Ha, et al.)