6 Tips for Sacroiliac Joint Treatment in Surgery Centers

In a session titled "New Advances in Sacroiliac Joint Problems" at the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago, Richard A. Kube, MD, CEO, founder and owner of Prairie Spine and Pain Institute, discussed tips for SI joint treatment in ambulatory surgery centers.

1. Patients must first meet the criteria for SI joint treatment. Dr. Kube said that patients may be candidates for SI fusion if they have experienced a failed combination of previous treatments, experience chronic pain for more than six months, and would have reasonable expectations post-surgery.

2. The iFuse implant system is one option for SI joint treatment. The iFuse implant system is a minimally invasive lateral approach for SI joint treatment, said Dr. Kube. No bone graft is used, and implants are fixated across the SI joint. The procedure uses titanium implants coated with a porous plasma spray.

3. The DIANA cage is a second option for SI joint treatment. The DIANA cage is a posterior approach for lumbar interbody fusion, said Dr. Kube. It involves a self-tapping, hollow and fenestrated cage, and the implants are meant to distract the joint. "The procedure is not FDA approved at this point," he said.

4. A third option for SI joint treatment is SImmetry Animation. SImmetry Animation involves a 15 mm incision that drills down to the joint, and requires dilation up over a series of different working cannulas, said Dr. Kube. "Through the working cannula, the device places an extendable retractable cam device out into the SI joint," he said. "You are then able to sequentially go through and prepare a 25 mm diameter section."

5. All SI joint procedures have been successful for Dr. Kube. In all eight instances where Dr. Kube has performed SI joint procedures, patients have experienced SI joint pain relief. The patients, all of whom were involved in litigated workman's compensation cases, averaged 50 percent pain relief in six months. "This treatment is good for patients who don't get response from the usual therapy injection," Dr. Kube said.

6. SI joint treatment is becoming increasingly common. According to Dr. Kube, more minimally invasive solutions for SI joint treatment are being developed, and the procedure will become a significant part of surgery practices. "SI fusion is a hot topic right now," he said. "There is a real population of folks out there with 'failed back syndrome,' with an original misdiagnosis of SI joint problems." The procedure will become increasingly popular as patients are correctly diagnosed, he said.

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