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Old 02-12-2009, 10:34 PM
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mmglobal mmglobal is offline
Join Date: Sep 2006
Posts: 2,511

I just had another conversation with Dr. Stark.

I asked about RF ablations for painful SI joints, much like we see in other area (facets). It has been tried with little success and he does not do them. He says that the SI is too highly inneverated from several sources, so it's not reasonable to consider ablation. You have to either ablate too much, or not do a complete ablation... hence the poor results. (This is me trying to paraphrase what Dr. Stark said... If I'm mistating this, I hope he'll let me know so I can correct this.)

The most important part of our conversation had to do with the discussion of hip dysfunction as it relates to SI pain. Yes, hip issues that cause alignment or mechanical issues can increase the loading on the SI joints, much like a fused or collapsed spinal segment can overload the adjacent segment.

I was specifically asking hypothetical questions about an anonymous person who was pain free for some time following an SI injection, but has hip replacement surgery coming up. While it's impossible to properly discuss any case without real data or examinations, he said that just like with the spine surgeries, he frequently sees patients who have hip replacement surgery with no improvement in their hip symptoms. Then, addressing the SI resolves the symptoms.

Remember, you can have degenerated joints that are not painful. It's possible for SI joint disfunction to mimic hip problems. Note that you can have hips that are painful and SI that is painful too. It may be that we need one, the other or both. However, if there is any reason to suspect possible SI involvement, I'd get properly evaluated by someone who knows SI joint dysfunction BEFORE undergoing hip surgery. Do your homework, make informed decisions.

Lastly, we discussed the improvements in fusion technology. We could not get into specifics because I had an appointment, but the technology has advanced a long way from the SI fusions of old. I look forward to learning more!

All the best,

1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
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