Dr. Jared Crasto, MD

Occasionally, the SI joint can become irritated, painful, or arthritic. Problems with the sacroiliac joint can be caused by trauma, infection, or other issues. The main symptom of SI joint damage is pain in the lower back, hips, and thighs. This pain may become worse when rising from a sitting position. When non-surgical treatments such as medications and physical therapy are not effective at relieving pain, surgery may be considered as an option.

During SI joint fusion, a small incision is made on the side of the buttock near the hip. The surgeon removes the cartilage, a firm, smooth substance between the bones. Then the joint is fused by the placement of rods, screws, or plates that hold the sacrum and the pelvis together. This reinforces the joint, stabilizing the pelvis and helping to support the upper body. Patients may be able to stand and walk the very next day after surgery but will need crutches to get around for the first few weeks. Full recovery and return to normal activities takes up to a year as the tissue around the joint grows and heals.

Spinal cord injury medicine seeks to stabilize the spine and to alleviate the symptoms of spine damage. Practitioners of spinal cord injury medicine are called spinal cord injury specialists. Spinal cord injury medicine is an interdisciplinary field, meaning physicians of various specialties may be trained to treat spinal cord injuries.

Damage to the spinal cord may initially be diagnosed through X-ray, MRI, or CT scans. Patients can also undergo spinal exams to evaluate their sensory ability and strength. Injuries to the spinal cord can be complete (no feeling or sensation) or incomplete (some feeling or sensation remains). Conditions spinal cord injury medicine specialists may treat include:

• Paralysis, such as paraplegia (loss of function in the legs), or quadriplegia (loss of function from the neck down)
• Spine fracture or trauma, which can lead to impairment and/or significant pain
• Spinal infections
• Myelopathies, such as herniated disks, spinal tumors, and rheumatoid arthritis
• Inflammatory diseases such as ankylosing spondylosis, and degenerative conditions like Lou Gehrig's disease (ALS)

Treatment for spinal cord injuries often involves surgery, either directly after an injury occurs or at a later date. Surgery for spine injuries is intended to ease spinal compression and stabilize the spine. Surgical procedures can involve shifting vertebrae, removing bone, or altering spinal placement with implantable devices. Patients with significant spinal trauma may require urgent surgical intervention.

Surgical treatments can be complemented by rehabilitative physical therapy to improve mobility. Spinal cord injury specialists also treat complications arising from a spinal injury, such as respiratory or bladder conditions. Some patients with spinal cord injuries may require lifelong treatment. Spinal cord injury specialists aim to help these patients successfully adjust and lead an improved quality of life. An emerging treatment for spinal cord injuries is neural prosthetics, which replicate patients' lost nerve function. Neural prostheses may be used as artificial body parts or assistive devices that patients may cognitively control. Other assistive devices include wheelchairs and scooters.

Spinal cord injury specialists may collaborate with physical therapists, radiologists, neurologists, urologists, and orthopedists.