Sacroiliac joint fusion is a surgery that is increasingly being performed around the world to treat chronic pain caused by dysfunctional sacroiliac joints. This relatively modern procedure aims to permanently stabilize the SI joints through an internal fixation method. With more awareness and reliable diagnosis options available today, this condition is being recognized more frequently with estimates showing steep rises in caseloads in the last decade alone.
Anatomy and Function of the Sacroiliac Joints
The Sacroiliac Joints, also known as SI joints, connect the sacrum to the iliac bones of the pelvis on each side of the lower back. Although a ball and socket joint, it allows very limited movement which helps absorb stress during activities that involve bending and twisting of the torso. Any disruption in the joint’s ability to smoothly transfer forces can lead to pain in the pelvic region. The joints are located deep within the body making precise diagnosis difficult without advanced imaging. Due to their integral role in lower body movement and weight bearing, even minor dysfunction can significantly impact mobility and quality of life.
Rising Diagnosis and Recognition Globally
Studies tracking national hospital admission rates reveal substantial rises in sacroiliac joint dysfunction diagnoses over the last decade. In the United States alone, the number of documented cases has increased by over 85% from 2000-2010 according to reports. Similarly in the United Kingdom, the National Health Service data reflects a 70% growth in SI joint problem consultations in adults between 2005-2015. Experts attribute this surge to a combination of improved assessment methods now available as well as higher awareness among patients and clinicians regarding this debilitating yet treatable condition. MRI scans and diagnostic blocks are helping pinpoint the sacroiliac joints as the source of pain more definitively than before.
Surgical Intervention – Sacroiliac Joint Fusion
For patients who fail to get relief from conservative treatments like medication, injections and physical therapy, sacroiliac joint fusion surgery is increasingly being utilized as a definitive solution. The goal of this procedure is to solidly fuse the SI joints, eliminating mobility and transferring stresses to other parts of the pelvis and spine. There are various techniques employed but the most common involves preparing the joint surfaces, placing bone graft material between them, and securing it internally with plates, screws or other implants. A multicenter study found that 75-80% of patients experienced significant long term pain reduction with no or minimal adverse effects from the surgery. Advances in minimally invasive fusion methods have also made the recovery process less invasive and traumatic.
Rising Treatment Rates Globally
As non-surgical options are exhausted for more sacroiliac joint dysfunction patients worldwide, sacroiliac fusion surgeries are being performed at rapidly rising rates. Data from national joint registries and private payers indicate the volume of these surgeries doubled or more between 2010-2020 in many countries. The United States saw close to a 300% increase according to some estimates, performing over 85,000 such fusion procedures in 2019 alone. Similarly high growth rates have been observed in nations with universal healthcare like the United Kingdom, Canada, Germany and Australia where SI joint problems are being addressed more proactively. With favorable long term outcomes proven, sacroiliac fusion looks set to rise further as a mainstream treatment choice for chronic sacroiliac joint pain globally going forward.
Suboptimal Access to Care in Low Income Countries
Unfortunately, developing nations are lagging significantly when it comes to availability of sacroiliac joint care including specialist doctors, facilities and technologies required for reliable diagnosis and surgical treatment. A World Health Organization study reviewed public hospital records across Africa, Asia and Latin America, finding sacroiliac procedures were rarely if ever performed. Lack of funds, expertise and awareness keep proper access out of reach for millions globally. International health organizations are working to train local practitioners and invest in basic resources to address debilitating conditions like this that severely impact quality of life and productivity in underserved populations. Telemedicine may offer some initial solutions but focused efforts are still needed to narrow the glaring disparity in sacroiliac joint care availability between high and low income nations.
Projected Rise in Specialist Workforce
Doctors specializing in spine surgery have seen their workloads expand dramatically with sacroiliac joint fusion representing a large proportion of the increase. Training programs are ramping up to meet this growing demand for specialists experienced in minimally invasive fusion techniques. The American Board of Orthopaedic Surgery data shows over 500 fellowships in spine surgery were completed annually by 2020, a 50% jump from 2010 levels. Job projections by international healthcare advisory firms anticipate the number of spine surgeons performing sacroiliac joint procedures around the world will need to double over the next 10 years to adequately address rising caseloads. This will continue improving access globally while also creating many new skilled professional opportunities. Careers in adjunct areas like radiology, anesthesiology and physical therapy supporting sacroiliac joint care are also on the rise.
In summary, sacroiliac joint dysfunction is being recognized more frequently worldwide through improved assessment options. Rising diagnosis and treatment rates indicate it has emerged as a common yet treatable cause of chronic pelvic pain. While surgical fusion is proving highly effective long term for recalcitrant cases, more work remains in boosting access to specialists, facilities and technologies required especially in underdeveloped regions. Meanwhile increasing fellowship slots and workforce projections signal robust growth projected for this important sub-specialty in spinal care globally far into the future. With innovative minimally invasive procedures as well, sacroiliac joint fusion is set to profoundly improve quality of life for millions suffering from dysfunction of these crucial lower back joints.
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- Source: CoherentMI, Public sources, Desk research
- We have leveraged AI tools to mine information and compile it