Allegheny Health Network Neurosurgeons Use Innovative Titanium Implant to Correct Common Source of Chronic Back Pain

Wednesday, January 26, 2022

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PITTSBURGH - Allegheny Health Network (AHN) Spine Center neurosurgeons are among a select group in the region using an innovative technology called the SI-BONE iFuse Implant System to correct sacroiliac (SI) joint dysfunction, one of the most common causes of chronic back pain.

"SI-BONE's iFuse is the only technology of its kind for treating sacroiliac joint dysfunction that is supported by Level I evidence, which is the gold standard clinical research benchmark for demonstrating medical efficacy," said AHN neurosurgeon Nestor Tomycz, MD.

SI joint dysfunction, also called sacroiliitis, is an inflammation of one or both of the sacroiliac joints that are located where the lower spine and pelvis connect and are often referred to as the 'shock absorbers' for the spine. Sacroiliitis is responsible for an estimated 15 to 30 percent of all chronic lower back pain.

More often seen in women, SI joint dysfunction can be caused by pregnancy, small repetitive injuries that occur over time - such as sports related injuries - or significant traumatic injury.

Chrissy Brenner, 48, has spent most of her adult life dealing with chronic back pain from a fractured tailbone she sustained in a sledding accident as a teenager. "Being in constant pain is exhausting," she said. "It impacts nearly every aspect of your life."

Brenner's back pain intensified with pregnancy and the delivery of her son, extending across her hips and deeper into her lower back. Through the years, she sought relief through medication, which she didn't tolerate well, along with chiropractic treatments and physical therapy. As she exhausted each option, she felt her quality of life slipping away. "While the pain worsened and expanded, I became less active and had to give up doing things I enjoyed," she said. "I could barely walk without having to stop and rest-a lot."

Then, in 2018 Brenner struck out to explore medical resources beyond those she'd been accessing near her hometown of Hollidaysburg. Working with a Highmark member service representative who took a genuine interest in her issues, she was referred to Dr. Tomycz and AHN pain management specialist Michael Patterson, MD for evaluation.

"As neurosurgeons, we work closely with our pain management colleagues and radiologists to determine the true origins of a patient's chronic pain before considering surgical intervention," said Dr. Tomycz.

The pain management injections Dr. Patterson performed for Brenner provided temporary relief but did not remedy her problem entirely. Based on her test results and the findings of the Spine Center team of specialists, all signs pointed to a diagnosis of sacroiliitis.

"SI joint dysfunction is an under-recognized problem, and some patients undergo low back surgery or other surgeries that are unsuccessful because of an incorrect diagnosis," said Dr. Tomycz. "There is considerable overlap with the symptoms of degenerative lumbar spine disease, degenerative hip disease and SI joint dysfunction, and some patients have a combination of these contributing to their pain."

As much as she trusted her physicians, Brenner remained skeptical about her diagnosis. "I wasn't convinced that's what was wrong with me, and besides that, the idea of having back surgery terrified me," she said. "I needed time to think it over."

Then, a 45-dollar investment abruptly changed her mind. "I bought a sacroiliitis belt from an ad on TV," she said. "I didn't put much stock in it, but I figured it couldn't hurt to give it a try." Wearing the belt eased Brenner's pain significantly, and that's when she knew she was indeed suffering from SI joint dysfunction and decided it was time to have the surgery.

Dr. Tomycz performed Brenner's minimally invasive SI joint fusion using the small triangular titanium iFuse implant to secure and stabilize her joint.

"I woke up from surgery with absolutely no pain," she said. "I couldn't believe it."

Just a few short months after her procedure, Brenner is delighted to be nearly pain-free and doing the things she loves, like attending concerts, camping and walking around her favorite city-Pittsburgh, with her son and future daughter-in-law. "This surgery gave me back my life."

"Treating chronic spine conditions is complex, and we are fortunate to have a team of specialists who are willing to embrace the latest surgical techniques, technologies and therapies to advance the discipline and the potential to transform our patients' lives," said Dr. Tomycz.