iFuse surgery for SI joint problems

iFuse surgery is performed in people with chronic (long-lasting) SI joint problems. iFuse is an implant system. With an iFuse implant, the sacroiliac (SI) joint is fixed (stabilized). This eliminates movement in the SI joint and provides pain relief.

What are SI complaints and the treatment options?

SI complaints are pain symptoms - around the buttock and lower back - that originate from the SI joint. The SI joint is the joint between the pelvis and the sacrum. This joint can cause many symptoms that resemble low back pain.
SI complaints are common. They are often difficult to distinguish from low back pain.

There are many treatment options for SI complaints:

• Physical therapy or pelvic therapy are the most recommended treatment options. The effect is usually significant. After treatment the patient is pain-free or has fewer symptoms.
• Medication. A doctor can prescribe pain medication. These medications can be taken for a short period. Sometimes this alone, or in combination with therapy, is sufficient to resolve the symptoms.
• Injection. A doctor can give an injection into the SI joint. This treats the SI joint directly with pain and anti-inflammatory medication.
• Pelvic belt. In pelvic instability, a belt can be worn around the pelvis. This can stabilize the pelvis from the outside. This is often a good aid during or after pregnancy.
• Surgery. When the above treatments do not work, surgery can be considered. This is always decided together with a doctor. The iFuse surgery is the most commonly performed operation for this.

What happens during an iFuse implant surgery?

In an iFuse surgery, (usually) three implants are used. These are placed into the SI joint to fuse the joint. This means there is no longer any movement. The implants are triangular in shape. In this way, rotation of the pelvis is also limited as much as possible. The implants are inserted through a small incision on the side of the buttock.
 

When can an iFuse surgery be performed?

In persistent SI complaints due to instability or wear-and-tear, an iFuse surgery can be performed. Surgery is always the last option of all treatment possibilities. So the surgery is only done when all other treatments have had no effect.

What are the advantages of an iFuse surgery?

After the iFuse surgery, the pain symptoms should decrease. People who undergo iFuse surgery are often also limited in walking, sitting, working, and sports. These activities should also be possible again after the surgery.

The advantages are:

• Pain reduction.
• Improvement in activities (standing, sitting, working, sports).

What are the disadvantages of an iFuse surgery?

As with any surgery, there are risks of infection. In addition, fusing one joint means another joint is loaded more. About 25% of operated patients have no beneficial effect from the iFuse surgery. Possible disadvantages include:

• Another joint is loaded more, which can cause symptoms.
• Infection during the surgery.
• More pain after the surgery. Every surgery has a risk of more pain. Many nerves run through the pelvic area. These can be affected, which can lead to pain or loss of function.
• Disadvantages of anesthesia.
• 25% have no beneficial effect from the surgery.

To undergo iFuse or not?

This is a decision made together with a doctor. Online, the procedure is often described as a miracle cure. Many patient experiences and studies show good results. But that is also the risk. Clinics highlight the positive stories, while the less positive experiences are sometimes forgotten.

Movement in the pelvis (no matter how small) is very important for good mobility of the trunk and legs. It is still unknown what the effects are of fusing this central part of the body. And one in four people has no beneficial result after the surgery; this is still quite a large percentage.

Ultimately, it is a decision you make together with the doctor or orthopedic surgeon. Are you considering having the iFuse surgery performed? Then ask for the figures (results) of the specialist who will operate on you. This can help you make the decision for yourself.