Brooklyn—Dr. Vagmin Vora of The Center for Musculoskeletal Disorders in New York and New Jersey became the first surgeon to perform the iFuse Implant System® (“iFuse”), a minimally invasive sacroiliac joint surgery, in Brooklyn. The groundbreaking procedure took place at Mount Sinai Brooklyn on August 3.
Following a motor vehicle accident, the patient (a woman in her 30s) had been complaining of back pain for close to a year. Nonsurgical methods, such as physical therapy and pain-management steroid injections, had not provided relief. Then, she found Dr. Vora.
Through a physical exam and a diagnostic injection (to isolate the pain), Dr. Vora accurately diagnosed the patient’s source of back pain as the SI joint, consequently recommending iFuse surgery (a surgery for which he underwent special training and previously performed in Manhattan).
The SI joint, which lies next to the bottom of the spine, connects the sacrum (the triangular bone at the bottom of the spine) with the iliac bone (pelvis), supports the weight of the upper body and shifts that load to the legs. Its shock absorption is vital in preventing the “impact forces” of walking or running from reaching the spine.
Dr. Vora points out, “It can be very difficult to diagnose lower back pain. Also, it has not been thought to typically emanate from the SI joint. However, I became more aware of this connection with published research, particularly when the North American Spine Society took a position that the SI joint is a genuine cause of back pain.”
The SI joint has been detailed in medical literature as the cause of chronic low back pain 25 percent of the time. Surgery may be indicated following a period of conservative treatments, such as physical therapy and pain injections. Although open SI joint fusion has been performed since the 1920s, this surgical technique has fallen out of favor with the introduction of minimally invasive options, such as iFuse.
Surgery with iFuse, which Dr. Vora says takes about 30 to 45 minutes, entails inserting stabilizing implants (three titanium rods about the size of the little finger) in the joint through a small incision in the buttocks. States Dr. Vora, “The minimally invasive surgical technique I have utilized is quite novel and efficient, particularly to the extent that it has significantly altered the morbidity and recuperation from previous open SI joint fusions.”
Dr. Vora says that his Brooklyn patient is doing well and has reported no signs of her prior pain related to the SI joint. He concludes, “It is very gratifying when surgery works for a patient. With those who benefit, it can be quite dramatic and life-altering. They are given back their normal way of life.”
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