Aaron Bianco, MD recently completed his 200th sacroiliac (SI) joint fusion procedure using the iFuse Implant System (iFuse) to treat patients experiencing significant lower back pain extending from their sacroiliac joint. One of few surgeons skilled in this procedure, Dr. Bianco trained in this procedure during his fellowship at Brown University. He has since treated patients with SI joint pain from not only Central New York, but nearby states and even Canada.
The SI joint is a significant cause of lower back pain, and clinical publications have identified it as a pain generator in 15 – 30% of chronic lower back pain patients. In addition, the SI joint is a pain generator in up to 43% of patients with continued or new onset lower back pain after a lumbar fusion. It is common for pain from the SI joint to feel like disc or lower back pain. “Although many patients present to physicians with lower back pain, it has been a hard condition to diagnose,” says Dr. Bianco. “Thankfully, we are beginning to recognize this condition more quickly as awareness of the condition grows.”
“To diagnose and identify patients potentially eligible for the iFuse procedure takes more than just one consultation and often even an MRI can be inconclusive,” comments Dr. Bianco. “Patients with lower back pain often undergo one or more non-invasive treatments which can include physical therapy, sessions with a chiropractor or pain management.” The most relied upon method to accurately determine whether the SI joint is the cause of lower back pain symptoms is to inject the SI joint with a local anesthetic. The injection will be delivered under either X-ray or CT guidance to verify accurate placement of the needle in the SI joint. If symptoms are decreased by at least 50%, it can be concluded that the SI joint is either the source of or a major contributor to lower back pain. For a patient to be eligible for the iFuse procedure, they must first two receive two such injections.
For patients eligible for the iFuse procedure, the procedure takes approximately one hour. The procedure is done through a small incision and inserting triangular-shaped titanium implants across the joint to maximize post-surgical stability and weight bearing capacity. The minimally invasive surgery can be performed as an outpatient at a hospital or at the Specialists’ One-Day Surgery Center (SODS), which is a locally owned ambulatory surgery center that provides safe, convenient and affordable same day surgery for patients. “Many patients are pleased with having the option of the procedure at SODS where only elective orthopedic procedures are performed, knowing their risk of being exposed to patients with other illnesses is much less than in a hospital setting,” added Dr. Bianco.
Once the procedure is completed and patients return home for recovery, they are instructed to rest and keep activity minimal. After approximately two weeks, most patients can return to regular daily activity. Dr. Bianco indicates that approximately 70% - 80% of his patients see significant improvement in pain within two to six months. “It is gratifying to help my patients lessen their pain and see them return to normal daily activity,” commented Dr. Bianco.
“There are many causes for SI joint pain and dysfunction, and it affects a wide demographic of patients, ranging in ages from their 20s to their 70s, but the ratio is about 4:1 female to male,” commented Dr. Bianco. The large female patient population is due to stress placed on the SI joint during pregnancy and childbirth. Other causes of SI pain include, but are not limited to, traumatic injury, arthritis, previous lumbar fusion, or an infection.
Dr. Bianco is continuing to take new patients, and his SOS colleague, Dr. Justin Iorio, has also been trained in the iFuse procedure and is accepting patients. Click to find out more information or contact SOS to see if this treatment may be appropriate for you at (315) 251-3232 .