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Background

I have been a police officer for over 20 years. During that time, I have worn a duty belt around my hips that weighs approximately 25 lbs. I started to notice pain in my lower back in 2015. I went to my primary care physician (PCP) who suggested lighter duty equipment would be helpful. I also went to a chiropractor. I saw him numerous times for manipulation. I then started to notice pain in my left buttock area. I was only taking ibuprofen at the time, which dulled the ache in my low back and buttock area. My chiropractor felt my pain might be coming from my SI joint. The manipulations did not give me much relief from my pain, so I was sent for x-rays and an MRI. The MRI showed a disc bulge at L5-S1 and I was referred to a spine specialist. After reviewing my records, the spine specialist thought I would benefit from a lumbar nerve root block. I had the block, and it did help for a short time, but then my pain returned.

I decided to go back to my PCP at the end of 2016. I had a constant annoying ache that varied in intensity from day to day and with my activity level. I was prescribed Flexeril and prescription strength ibuprofen. In July of 2017, my pain changed. I developed decreased range of motion in my upper back, neck pain, and pain shooting down my left arm. My low back and buttock pain also became more severe. I was sent for a cervical spine MRI which showed serious spinal cord compression at C5-6, C6-7. I had a 2-level cervical decompression and fusion which did help my upper back, neck, and arm pain but my lower back pain remained. I returned to work 12 weeks after my surgery. I was eventually sent for another lumbar MRI which again showed a disc bulge at L5-S1. I now also had leg pain that was debilitating. I went back to pain management for a facet joint injection and a caudal nerve root block. These interventions did help with my pain for a short period of time. At this point I was unable to mow the lawn, couldn’t sit on my left butt cheek at my daughter’s field hockey games and was very irritable with my family. I was still working full time but had to modify my job duties.

In 2018, I went back to my PCP, and I was prescribed more muscle relaxants and an oral steroid. I then decided to see a different pain management specialist. He sent me for repeat caudal and lumbar facet injections. We then tried a lumbar facet rhizotomy. My pain was improved for several weeks but then returned as more of an increased stabbing pain. The pain specialist thought maybe my pain could be coming from my SI joint. I was sent for a CT scan of my SI joint which did show some changes.

I was referred to a spine surgeon who performs SI joint fusions. After reviewing my records and doing a physical examination, he felt I might benefit from an SI joint fusion. I had a series of 3 SI joint diagnostic injections. Each of these gave me several hours of pain relief. Based on my history, physical examination and response to the injections, he offered me the option of a surgical intervention.

January 2020, I had a left SI joint fusion utilizing the iFuse Implant System. The intense stabbing SI joint pain was gone immediately, I only had surgical pain. I had some bruising and swelling. I used ice and ibuprofen for pain control and took an oral steroid dose pack. I utilized a walker for several weeks then advanced to a cane and eventually was walking on my own at 4 weeks. I went to physical therapy and returned to work in March 2020.

Unfortunately, I took a fall at work and developed pain in my right SI joint. I went back to my surgeon. He discontinued the physical therapy, put me back on leave from work and started me on an oral steroid dose pack. I was told to rest and take it easy. I was able to resume physical therapy and return to work in 2 weeks. The therapist said my right SI joint was “out” and she was able to manually adjust it giving me pain relief. I wore an SI joint belt, but it did not help with my pain. I returned to my surgeon in August 2020. We repeated the series of 3 SI joint diagnostic injections on the right side. Once again, they all provided several hours of pain relief. In September 2020, I had a right SI joint fusion. My surgical pain was less this time and I returned to walking on my own sooner. I was able to return to my job as a police officer 6 weeks after my second iFuse procedure.