The sacroiliac joint connects the bottom of the spine (sacrum) with the pelvic bone. The sacroiliac joint is the largest joint in the body and serves to distribute forces from the upper body to the lower limbs. The sacroiliac joint is normally subjected to large shearing forces. Sacroiliac joint dysfunction can arise due to trauma, degenerative changes, pregnancy, and inflammatory arthritis such as ankylosing spondylitis. Only 10-20% of patients who present with back pain actually have pain originating from their sacroiliac joint. Patients who have undergone spinal fusion surgery have a higher possibility of pain arising from the sacroiliac joint. This is thought to be due to abnormal mechanical stress on the sacroiliac joint following spinal fusion.

Sacroiliac joint dysfunction can be a great mimicker of other spinal conditions.

Patients with sacroiliac joint dysfunction may experience pain localised to one or both sides of the buttocks. Pain can often radiate down the back of the leg mimicking the symptoms of sciatica.

The diagnosis of sacroiliac joint dysfunction is based on clinical examination. Sometimes other conditions, such as back problems, can co-exist with sacroiliac joint dysfunction. Hence the diagnosis is often confirmed by performing a sacroiliac joint injection. The injection consists typically of both local anaesthetic to “numb” the joint and steroids to help reduce inflammation of the joint. If the injection provides a significant reduction in pain, this means the sacroiliac joint is either the source, or a major contributor, to the symptoms.

Dr Lee focuses on obtaining an accurate diagnosis before commencing treatment.

Most patients with sacroiliac joint dysfunction can be treated successfully without surgery. Treatment usually involves a short course of anti-inflammatory medication, activity modification, physiotherapy and use of a pelvic brace.

If non-operative treatment fails, then surgery may be recommended for patients who suffer from chronic sacroiliac joint pain.

Minimally invasive sacroiliac joint fusion

Dr Lee performs minimally invasive sacroiliac joint fusion for patients who have exhausted conservative treatment options. Dr Lee utilises intraoperative navigation when performing sacroiliac joint fusion. The procedure involves placing cages across the sacroiliac joint through small incisions on the side of the pelvis to stabilise the joint. This eliminates motion of the sacroiliac joint creating a reduction in joint pain.

Dr Lee will discuss this option in detail with you if surgery is required including all the risks and benefits of undergoing sacroiliac joint fusion.