Ralf Wagner1, Albert E Telfeian2, Guntram Krzok3, Menno Iprenburg4. 1. Ligamenta Spine Centre, Frankfurt am Main, Germany. 2. Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. Electronic address: ATelfeian@Lifespan.org. 3. SRH Hospital, Waltershausen-Friedrichroda, Germany. 4. Spine Clinic Iprenburg, Veenhuizen, Netherlands.
Abstract
BACKGROUND: Sacroiliac (SI) joint fusion is considered for the treatment of degenerative sacroiliitis. The procedure has increased in popularity for patients who have exhausted less invasive treatment options since the development of percutaneous SI joint fusion systems. One possible complication of the procedure is a sacral radiculopathy that can result from compression of the S1 nerve by the SI joint fusion implant. Others have described revising the implant by removing it and replacing it with a shorter implant. METHODS: Here we describe a minimally invasive endoscopic S1 nerve root decompression that does not require removing or revising the SI fusion implant. RESULTS: The postoperative course was uneventful, and the patient's radicular pain improved immediately after surgery. Six months after his endoscopic procedure, the patient had no clinical symptoms related to the S1 nerve root compression and was symptomatically improved from her sacroiliac pain. CONCLUSIONS: This technical note is for others to consider as a possible minimally invasive solution for the treatment of lumbar radiculopathy after a minimally invasive SI joint fusion procedure.
BACKGROUND: Sacroiliac (SI) joint fusion is considered for the treatment of degenerative sacroiliitis. The procedure has increased in popularity for patients who have exhausted less invasive treatment options since the development of percutaneous SI joint fusion systems. One possible complication of the procedure is a sacral radiculopathy that can result from compression of the S1 nerve by the SI joint fusion implant. Others have described revising the implant by removing it and replacing it with a shorter implant. METHODS: Here we describe a minimally invasive endoscopic S1 nerve root decompression that does not require removing or revising the SI fusion implant. RESULTS: The postoperative course was uneventful, and the patient's radicular pain improved immediately after surgery. Six months after his endoscopic procedure, the patient had no clinical symptoms related to the S1 nerve root compression and was symptomatically improved from her sacroiliac pain. CONCLUSIONS: This technical note is for others to consider as a possible minimally invasive solution for the treatment of lumbar radiculopathy after a minimally invasive SI joint fusion procedure.