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SI Joint Fusion

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Posted 6/18/2016 10:24 PM (GMT -5)
Has anyone out there had either the new minimally invasive SI joint fusion. OR. The old SI joint fusion procedure? In the US at this point most insurances, including mine, do not pay for the new method. And most doctors refuse to do the surgery the old way because it is a huge procedure with poor outcomes.
I suffer from debilitating SI joint pain and feel there is no hope for me. Anyone else out there in the same situation or have any suggestions? Barring that, anyone got a couple hundred thousand bucks they would just love to give away? .....never hurts to ask, right?
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Posted 6/19/2016 3:18 PM (GMT -5)
Mary, we have had some members have this surgery "old style". They do not participate any longer here. I suggest doing a forum search on SI joint fusion, at least you can read the old threads about it. We ask that you don't post on the older threads as we like to keep them off of the main page. Thanks.
Posted 6/21/2016 8:58 AM (GMT -5)
Mary:
Is there a particular reason that you have been denied the I-Fuse surgery?

As a physical therapist, I was often taken aback by the lack of physician insight into the mechanics of the SI joint as a contributor to low back pain. I would see patients who had been to see orthopedists with spine specialty - with no evaluation of the SI joint as a possible contributor to the low back pain that they were experiencing.

Low back pain has 3 points of origin, the so-call low back triad: The hip, the lower thoracic and lumbar spine, and the SI joint.

The I-Fuse surgery is a relatively simple procedure, when looking at the broad spectrum of surgeries. It does require that the orthopedist have specific training in using the I-Fuse system - how to place the titanium rods across the SI joint. I-Fuse is a key-hole surgery, requiring about a 2 inch incision. It is performed as an out-patient surgery, depending on the patient's overall health profile.

Success with the procedure has been good according to patient responses post-surgery.

Have you seen an orthopedist with continued education training/accredidation on the I-Fuse system for an assessment of your particular situation? An I-Fuse specialist may be better able to petition your medical insurance provider for coverage of the procedure.

As an outpatient procedure, it's cost is not in the 10's of thousands of dollars. The outlay to an insurance company is not substantial. When successful, the procedure can eliminate or markedly reduce ongoing SI joint pain for those that are suffering.

If I were you and had intractable SI pain, I would push a bit harder for evaluation of the I-Fuse procedure.

I hope that there is a light of possibility for you,
- Karen -
Posted 6/21/2016 6:40 PM (GMT -5)
Dear Seashell
Thanks for your response. The problem with my getting the SI Joint fusion surgery is not that they think it would not benefit me. My insurance co calls the I-Fuse procedure an experimental/investigative procedure and will not pay for it. My surgeon's office personnel said they cannot even submit it for pre-approval as the FDA has not even assigned it a code. I'm sure we're talking about the new minimally invasive method you are referring to. Unless there is another new method my neurosurgeon hasn't heard of. We could try to pay for it ourselves but have been told it would be close to $150,000.00 which would wipe us out. Have you as a physical therapist worked with anyone who had this surgery done the old way? My husband is afraid to let me even try it as it is very invasive. So I am very disheartened. Thanks again for your response.😌
Posted 6/21/2016 7:59 PM (GMT -5)
Have been getting emails from:

Sue O'Dell (sueo@si-bone.com)


for a couple of years. I have not had any treatment for SI joint problems, I have other issues w/ my back. But, contact her if you want. Their website seems helpful.

Just a thought.

Good luck, hope you find something that helps!!
Posted 6/21/2016 10:56 PM (GMT -5)
The I-Fuse technique has been used for several years. At least, I know of patients who had the I-Fuse procedure done in 2012.

You can go to the I-Fuse site's home page/web-page. You can see testimonials of real-life people who have undergone the procedure. Perhaps you can contact representative of I-Fuse directly, by telephone or e-mail.

The open surgical approach for SI joint fusion does not have a good track record. Clinically, I did not see too many "good" outcomes. The weight-bearing and loading forces translated down through the pelvis/SI joint make stabilization of the joint to allow for fusion post open procedure almost impossible.

Keep faith and hope.

If the I-Fuse procedure is not available to you in the present due to insurance constraints, likely it will be in the future as the procedure gains more wide-spread recognition and validation.

Are you using a 4-wheeled walker to help reduce weight bearing when walking? Using a walker, even if only part-time each day, can help keep reduce SI joint pain and inflammation. I prefer the 4 wheeled walkers as they replicate the natural step pattern more efficiently than a standard front wheeled walker. It might keep your pain tolerable until the I-Fush procedure is available to you.

Bottom Line: I would not discount the I-Fuse procedure as a possibility in your future. The procedure needs more time to gain validity in the medical community.

Visit the I-Fuse web site and talk with its medical representatives. They may have some additional ideas for you.

I will say a gentle prayer for you,
- Karen -
Posted 6/22/2016 12:29 AM (GMT -5)
Thanks again Seashell...As a matter of fact I do have one of those kind of walkers. It was my mother's and I have used it following my six previous lower spine surgeries. My surgeon told me that the fusion surgeries I underwent have put more pressure on my SI joint. You are the only one who has given me such practical advice. This is one of those, "Now why didn't I think of that" moments. I'm certainly going to try this.

And many thanks to you all for your responses. They are much appreciated!!! God Bless!
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