27280 Arthrodesis, open, sacroiliac joint, including obtaining bone graft, including instrumentation, when performed

Name of the Procedure:

Arthrodesis, open, sacroiliac joint (SI joint fusion), including obtaining bone graft and instrumentation.

Summary

Arthrodesis of the sacroiliac joint, commonly called SI joint fusion, is a surgical procedure that involves permanently joining the sacroiliac joint to alleviate pain or dysfunction. This is achieved by placing a bone graft in the joint space and securing it with special instruments.

Purpose

This procedure addresses chronic sacroiliac joint pain or dysfunction that's resistant to conservative treatments. The goal is to stabilize the joint, reduce pain, and improve mobility.

Indications

• Chronic sacroiliac joint pain
• SI joint dysfunction or instability
• Failed conservative treatments (e.g., physical therapy, medications)
• Degenerative arthritis in the SI joint
• Traumatic injury to the SI joint

Preparation

• Fasting: Patients typically need to fast for 8 hours before surgery.
• Medication Adjustments: Certain medications may need to be paused; consult with your doctor.
• Pre-operative Assessment: Includes physical examination, imaging studies (e.g., X-rays, CT scans), and blood tests.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: A surgical incision is made over the sacroiliac joint.
3. Bone graft: Bone graft material, which may be autograft (from the patient) or allograft (donor bone), is prepared.
4. Fusion: The joint surfaces are prepared and the bone graft placed between them.
5. Instrumentation: Special screws or rods are used to secure the graft and hold the joint in a fixed position.
6. Closure: The incision is closed with sutures or staples.

Duration

Typically, the procedure takes about 2 to 3 hours.

Setting

Hospital surgical suite.

Personnel

• Orthopedic or Spine Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Blood clots
• Nonunion (failure of the bone to fuse)
• Adverse reaction to anesthesia

Benefits

• Significant reduction or elimination of SI joint pain
• Improved mobility and function
• Long-term stability of the SI joint Results may be seen within a few weeks to months post-surgery.

Recovery

• Hospital Stay: 1 to 3 days.
• Post-procedure care: Pain management with medications, wound care.
• Physical Therapy: May begin a few weeks after surgery.
• Activity Restrictions: Avoid heavy lifting and strenuous activities for several months.
• Follow-up appointments: Regular visits to monitor healing and progress.

Alternatives

• Physical Therapy
• Pain Management Techniques (medications, injections)
• Use of sacroiliac joint belt or brace
• Radiofrequency neurotomy

Patient Experience

• During Procedure: Patient is under general anesthesia and will not feel anything.
• After Procedure: Pain and discomfort managed through medications. Gradual increase in activity levels.
• Long-term: Most patients experience significant pain relief and improved quality of life, though full recovery and fusion may take several months.