Having suffered from chronic unbearable pain in her right lower back for the past eight years, which worsened since her last child birth a year ago, the patient was referred to Aster Medcity in Kochi, India, to undergo a percutaneous Ilio-sacral screw fixation under neuronavigation guidance.
The patient had previously received treatment in the form of sacroillitis joint injections at multiple hospitals in Oman, Thailand and India, however, the pain persisted. Failing to get long-term relief, she visited the Spine Clinic at Aster Medcity, where the diagnostic investigations confirmed chronic sacroillitis on the right side.
She was counselled about minimally invasive sacrolilac joint fusion as prolonged conservative treatment had failed. The percutaneous ilio-sacral screw fixation was performed by a team led by Dr Jacob Eapen Mathew. Simultaneously, minimally invasive sacroliac joint fusion was done with a mixture of bone graft, hydroxyapatite and recombinant Bone morphogenetic protein (rBMP). After surgery she was ambulated on the third day and she reported excellent pain relief and return of functional ability.
“Sacroiliac joint fusion is a definitive treatment in chronic sacroiliitis when conservative treatment fails. Sacroiliitis, which is a common cause of chronic back pain, is most often misdiagnosed or treated inadequately. Open surgery for sacro-iliac fusion involves a lot of morbidity and a long recovery period. Minimally invasive SI joint fusion reduces the morbidity and vastly shortens the recovery period,” said Dr Mathew.
He added, “We were able to perform this procedure with high accuracy with the help of intraoperative 3D C arm (using reconstructed CT like images) and the Stealth station navigation system. This system which is akin to the GPS found in cars enables high accuracy near critical nerves. We were also able to perform additional minimally invasive posterior SI joint fusion with keyhole ports. The SI joint has a complex anatomy with multiple ligamentous and muscular attachments around. We performed this fusion with minimal disruption of the surrounding anatomical structures.”
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