iFuse surgery for SI joint problems

An iFuse operation is performed in people with chronic (long-lasting) SI complaints. iFuse is an implant system. With an iFuse implant the sacroiliac (SI) joint is fixed (stabilised). This prevents movement in the SI joint and provides pain relief.

What are SI joint symptoms and the treatment options?

SI joint symptoms are pain complaints 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 lower back pain.
SI joint symptoms are common. They are often difficult to distinguish from lower back pain.

There are many treatment options for SI joint symptoms:

• Physiotherapy or pelvic physiotherapy are the most frequently advised options. The effect is usually considerable. The patient is symptom-free or has fewer symptoms after treatment.
• Medication. A doctor can prescribe pain medication. These medicines can be taken for a short period. Sometimes this alone is sufficient, or in combination with therapy, to get rid of the symptoms.
• Injection. A doctor can give an injection into the SI joint. In this way the SI joint is treated directly with painkillers and anti-inflammatories.
• Pelvic belt. In pelvic instability, a belt can be worn around the pelvis. This can stabilise 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 operation is the most commonly performed operation for this.

What happens during an iFuse implant operation?

In an iFuse operation, usually three implants are used. These are placed in the SI joint, thereby fixing the joint. This eliminates movement. The implants are triangular in shape. In this way, rotation of the pelvis is also limited as much as possible. Through a small incision at the side of the buttock, the implants are inserted.
 

When can an iFuse operation be performed?

With long-standing SI joint symptoms due to instability or wear, an iFuse operation can be performed. Surgery is always the last option of all treatment possibilities. So the operation is only done when all other treatments have no effect.

What are the benefits of an iFuse operation?

The iFuse operation should reduce pain symptoms. People who undergo an iFuse operation are often also limited in walking, sitting, working and sport. These activities should also be possible again after the operation.

The benefits are:

• Pain reduction.
• Improved activities (standing, sitting, working, sport).

What are the disadvantages of an iFuse operation?

Every operation carries a risk of infection. In addition, fixing a joint means that another joint will be loaded more. About 25% of operated patients do not benefit from the iFuse operation. Possible disadvantages include:

• Another joint is loaded more, which can cause symptoms.
• Infection during the operation.
• More pain after the operation. Every operation carries risks of more pain. Many nerves run in the pelvic area. These can be affected, which can lead to pain or loss of function.
• Disadvantages of anaesthesia.
• 25% have no beneficial effect from the operation.

To have iFuse surgery or not?

This is a decision that is made together with a doctor. On the internet, the procedure is often described as a miracle cure. Many patient experiences and studies show good results. But this is also the danger. The positive stories are discussed prominently by clinics, while the less positive experiences are sometimes forgotten.

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

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