DANBURY, Connecticut, August 10, 2016 Every year, 31 million Americans grumble “Oh my aching back.” Back pain can range from a dull, constant ache to a sudden, sharp sensation that leaves the person incapacitated. Pinpointing the source of the pain and proper treatment is complicated enough, but what if the pain isn’t really caused by a problem with the spine?
David Bomback, MD a spine and scoliosis surgeon with Connecticut Neck & Back Specialists in Danbury, who performs surgery at Danbury Hospital, is helping patients find relief by treating a little-known condition called sacroiliac joint dysfunction. Dr. Bomback is the first surgeon at Danbury Hospital to treat the condition with a sacroiliac joint fusion procedure and one of only a few surgeons in the entire state.
Where is the sacroiliac joint?
The sacroiliac joint connects the sacrum, the lowest bony segment of the spine, with the pelvis. The sacroiliac joint transmits most of the load from the upper body to the lower limbs, acting as a shock absorber in relieving forces on the spine. The joint is reinforced and supported by very strong ligaments. Occasionally, these ligaments can become too loose or too stiff so that the joint itself becomes arthritic, leading to persistent pain.
What causes sacroiliac joint dysfunction?
Sacroiliac issues are most commonly seen in mothers who have ligament loosening due to pregnancy, patients who have suffered trauma from an injury or accident, patients with certain arthritic conditions, and patients with previous lower back surgery (especially previous lumbar fusions). Approximately 25 percent of patients who visit spine surgeons actually have sacroiliac pain as that cause of his or her back pain rather than true lumbar (lower back pain).
Tough to Diagnose
Unfortunately, most tests including MRIs, X-rays, and CAT scans do not detect sacroiliac joint dysfunction, making the diagnosis challenging.
“The diagnosis is truly made by sitting down and talking to the patient and getting an appropriate history, as well as a physical exam consistent with sacroiliac joint dysfunction,” explains Dr. Bomback. “When I examine a patient with sacroiliac pain, I stress the sacroiliac joint in a number of ways to see if I can elicit and/or reproduce the patient's pain.”
Common Causes of Back Pain
The vast majority of low back pain is mechanical in nature, meaning damage to a vertebra of the lower spine. In many cases, it is caused by general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older. Sprains, strains and traumatic injury are also contributors.
According to the National Institute of Neurological Disorders and Stroke, about 80 percent of adults experience low back pain at some point in their lifetimes. It is the most common cause of job-related disability and a leading contributor to missed work days. About 20 percent of back pain sufferers develop chronic pain with persistent symptoms lasting over one year. In some cases, treatment successfully relieves chronic pain, but in other cases pain persists despite medical and surgical treatment.
“Spinal surgeries at times can have a poor outcome if the diagnosis is made prematurely or incorrectly,” notes Dr. Bomback. “It is critical that the diagnosis of sacroiliac dysfunction is made appropriately, often times after diagnostic injections.”
The nuts and bolts of sacroiliac joint fusion surgery
The surgery involves a minimally invasive approach, placing three screws across the sacroiliac joint, bridging the spine to the pelvis to eliminate any abnormal motion thus allowing the joint to fuse over time. The surgery significantly reduces and oftentimes completely relieves the pain. An incision less than one inch in size is made through a tiny tube guided by a live X-ray. The surgery takes approximately 30 minutes and there is minimal and often no blood loss. The patient can usually go home the same day or occasionally after a one night hospital stay.
“The procedure has been around for approximately five to seven years,” said Dr. Bomback. “To date, approximately 19,000 patients have had the surgery in this country. We feel it is likely a permanent solution to the cause of their lower back pain and therefore offers an improvement in their quality of life.”
For more information on sacroiliac joint fusion surgery or to learn if you are a candidate for the procedure, please call 203-744-9700 or visit www.ctneckandback.com.