27279 Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device

Name of the Procedure:

Arthrodesis, Sacroiliac Joint, Percutaneous or Minimally Invasive (Indirect Visualization), with Image Guidance, includes Obtaining Bone Graft when Performed, and Placement of Transfixing Device

Summary

Arthrodesis of the sacroiliac joint is a minimally invasive surgical procedure to permanently merge the sacroiliac joint using image guidance. The surgery involves the use of small surgical instruments and an image-guided approach to place a bone graft and transfixing device, which helps stabilize the joint.

Purpose

This procedure is designed to relieve pain and improve stability in the sacroiliac joint, which connects the spine to the pelvis. The primary goals are to reduce chronic pain, enhance joint strength, and improve overall mobility.

Indications

• Chronic lower back pain attributed to sacroiliac joint dysfunction
• Sacroiliac joint arthritis or degenerative joint disease
• Traumatic injury to the sacroiliac joint
• Failure of non-surgical treatments like physical therapy, medications, or injections

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments to certain medications, especially blood thinners, will be necessary.
• Preoperative imaging studies such as X-rays, MRIs, or CT scans are required for planning.

Procedure Description

1. The patient is positioned appropriately, and local or general anesthesia is administered.
2. Small incisions are made near the sacroiliac joint.
3. Using image guidance, the surgeon inserts instruments to prepare the joint surface.
4. A bone graft, often taken from another part of the patient's body or a donor, is placed between the joint surfaces.
5. A transfixing device is inserted to stabilize the joint, promoting bone fusion.
6. The incisions are closed, and the area is bandaged.

Duration

The procedure typically takes around 1 to 2 hours.

Setting

The procedure is performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic or spine surgeon
• Anesthesiologist
• Surgical nurses
• Radiologist or imaging technician

Risks and Complications

• Infection
• Blood clots
• Nerve damage
• Non-union or incomplete fusion of the joint
• Device failure or displacement
• Allergic reaction to anesthesia

Benefits

• Significant pain relief
• Improved joint stability
• Enhanced mobility and quality of life These benefits are usually observed within a few weeks to months post-surgery.

Recovery

• Patients typically need to stay in the hospital for 1-2 days.
• Pain management with medications and physical therapy is essential.
• General recovery time ranges from a few weeks to a few months.
• Avoid heavy lifting and strenuous activities during recovery.
• Follow-up appointments for imaging and progress assessment.

Alternatives

• Physical therapy and exercise programs
• Medications including pain relievers and anti-inflammatories
• Injections such as corticosteroids or nerve blocks
• Radiofrequency ablation Each alternative has varying levels of effectiveness and may be less invasive, although often with less permanent results.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, mild to moderate discomfort is common, usually managed with pain medications. Patients might experience swelling and limited mobility initially, which gradually improves with recovery and rehabilitation efforts.