Our sacroiliac joints are located at the junctions of the sacrum and ilium on each side of the hips. They transmit forces exerted through the spine from the upper body down into the legs. This joint is designed to absorb shock forces, but it can turn into a source of serious pain for many patients.
At Summit Healthcare Pain Clinic Associates, we now offer a new approach to solving this pain. It’s called the CornerLoc™ SI Joint Stabilization System, and it gives us a minimally invasive surgical option to create stabilization and fusion in the SI joint.
What Is the Sacroiliac Joint?
The sacroiliac joint connects the sacrum to the pelvis. The sacrum is a triangular bone at the bottom of the spine, below the lumbar region of the spine and above the tailbone. It consists of five fused vertebral segments. These segments move during our childhood, but fuse in early adulthood. The sacrum is connected to the pelvic bone, also known as the iliac crest, on the right and left sides at the sacroiliac joints. These joints act as shock-absorbing structures and typically only move a small amount.
What Is Sacroiliac Joint Dysfunction?
Sacroiliac joint dysfunction refers to pain in these joints. This usually occurs when the joint moves too much or too little. Hypermobility (too much movement) can be caused by injury to the ligaments in the joint or pregnancy. Hypomobility (too little movement) can be caused by degenerative joint diseases such as arthritis.
When the sacroiliac joints overcompensate for problems in nearby joints, they may become painful. Lumbar spinal fusion patients can develop pain in the sacroiliac joint due to reduced mobility in their lumbar spine segments.
Sacroiliac joint pain usually shows itself as pain in the lower back or buttocks, but it can spread to surrounding muscles that may spasm in response to joint dysfunction.
How Has Sacroiliac Joint Dysfunction Typically Been Treated?
Treatments for sacroiliac joint dysfunction have focused on alleviating the pain and restoring normal motion in the joint. A combination of rest, applying ice and/or heat, physical therapy and manual manipulation, and various pain medications have been the usual approaches. Some patients benefit from a pelvic brace when the joint is inflamed and painful.
In these methods don’t improve the patient’s pain, the last option has usually been injection of corticosteroid in combination with local anesthetic into the sacroiliac joint. This reduces the inflammation and reduces pain.
While these treatments with Dr. Trujillo are usually successful, in some patients their sacroiliac joint becomes a source of chronic pain.
What is the CornerLoc™ SI Joint Stabilization System?
The CornerLoc™ SI Joint Stabilization System gives us a new option. The CornerLoc™ system is designed to achieve optimal stabilization and fusion with only minimal invasiveness. After careful preparation of the sacroiliac joint, two CornerLoc™ allografts are placed orthogonally within the sacroiliac joint. These CornerLoc™ grafts create instant joint stability and an ideal environment for fusion.
How Is the Corner Loc™ Si Joint Stabilization System Placed?
Dr. Trujillo places the CornerLoc™ grafts through a posterior approach using two small incisions in the lower back. This provides simple and safe access to the sacroiliac joint. Through the two small incisions, Dr. Trujillo places the two CornerLoc™ allografts within the SI joint and this creates immediate stability. The grafts then begin fusing the two joints.
To implant the leads, patients are given local anesthesia and may also be sedated. Dr. Trujillo then inserts a hollow needle into the epidural space, through which the leads are passed. Patients awakened after the leads have been placed so that they can give Dr. Trujillo feedback on the placement. When all pain areas have been covered, the leads are connected to an external neurostimulator, which patients wear on a belt.
The trial period typically lasts about a week. If the patient experiences sufficient pain relief and wishes to proceed, Dr. Trujillo will move forward with the procedure to add the spinal cord stimulation implant. If the patient does not wish to proceed, the leads and external devices are removed.
What Is Recovery Like After Corner Loc™ Joint Stabilization Surgery?
These are minimally invasive procedures. Patients are typically walking within hours of their procedure. For the first two weeks, you’ll need to keep your incisions dry and your dressings in place. You won’t drive during this period. After two weeks, you can return to work and perform light duties. For up to six weeks, you won’t lift anything over 10 pounds. There can be some inflammatory pain as your body responds to the allograft, but this isn’t acute pain and doesn’t typically require anything beyond over-the-counter pain medication.
It’s important for patients not to “push” their recovery in any way. You don’t want to squat, jump, or place stress on the sacroiliac joint for that first six weeks. If you are patient, after about 12 weeks you can return to most forms of exercise, such as running or playing tennis.
How successful has the CornerLoc™ SI Joint Stabilization System been?
The FDA approved the CornerLoc triangular titanium implant grafts for sacroiliac joint fusion in 2008. Studies since that approval have shown the system to be very successful in helping patients with sacroiliac joint dysfunction. In those studies, 8 out of 10 patients who have undergone the CornerLoc™ procedure have reported excellent pain relief and functional improvement without serious complications.
Will Corner Loc Completely Treat My Joint Dysfunction?
These are relatively new treatments, so there isn’t any long-term data available yet. However, our patients from Show Low and the surrounding areas have found these fusion procedures with the CornerLoc™ system are easy to tolerate and significantly reduce their pain. This should be the only procedure required for long-term success.
Will I Need Treatment Again in The Future?
As mentioned above, the CornerLoc™ SI Joint Stabilization System is a relatively new approach to sacroiliac joint dysfunction, so there aren’t any long-term studies available. But these fusion procedures are designed to be permanent, one-time events.