Degenerative Sacroiliitis & Treatment - A Patient's Story | SI-BONE

James Mamary, MD

What resolved this physician’s SI joint symptoms due to degenerative sacroiliitis?

James's Story

After 10 years of suffering with lower back symptoms, Dr. James Mamary was diagnosed with degenerative sacroiliitis.  As a pulmonologist, Dr. Mamary often spends 8 to 10 hours in the bronchoscopy suite on his feet in a lead apron.  “All things that made the condition worse,” according to Dr. Mamary.

"Normal activities became problematic."

His personal life also suffered as he had to decrease activities with family and friends.  Every activity was a calculation of how much he would have to pay for it later.

After trying multiple therapies to relieve his symptoms, Dr. Mamary’s surgeon recommended the iFuse Implant System®. This minimally invasive procedure is designed to provide stabilization and fusion to the SI joint.

"SI joint pain limited the physical activities I used to enjoy."

The iFuse Implant System is intended for sacroiliac fusion for conditions including sacroiliac joint dysfunction that is a direct result of sacroiliac joint disruption and degenerative sacroiliitis. This includes conditions whose symptoms began during pregnancy or in the peripartum period and have persisted postpartum for more than 6 months. There are potential risks associated with the iFuse Implant System. It may not be appropriate for all patients and all patients may not benefit. For information about the risks, visit:

"I think my family notices that I smile more and that I don’t think twice about doing activities that I used to put my hands up and say no, I can’t do that.  

I’ve had low back pain for at least 17 years.

After 10 years of visiting doctors and having diagnostic testing I was diagnosed with sacroiliac joint dysfunction.

This low back pain really disrupted my life. 
I sort of lost interest in normal social activities, and it really limited the usual physical activities that I enjoyed from when I was a child – the backpacking, cycling, running, tennis.  All those things I gave up.

So I stopped doing anything that required running or even a heavy footfall.  I had to be careful coming down the stairs.  So if my left foot hit the ground hard I’d have pain and it would last for days.  

Bending at the waist was a problem.  I stopped getting things off low shelves or out of the kitchen from the bottom of drawers; I relied on my kids and my wife to help me with those kind of things.  

I had trouble playing with the kids.  That was probably the most disruptive thing in home life.  Just normal activities became problematic and I would do things sort of with the idea of how much am I going to pay for this later.  

He always needed to be thinking in advance of his actions, what the consequences might be, what he was going to suffer later if he twisted a certain way or if he reached a certain way and he would have to think about it before he did anything.  It was always on his mind that this could lead to pain.

I’m a physician.  Some of the work I do is physical. I do procedures. I’m a pulmonologist. We spend sometimes 8 or 10 hours a day in a bronchoscopy suite (with equipment) on our feet, sometimes wearing lead aprons – all things that certainly made this problem worse.

The iFuse procedure seemed intuitive to me and this is something that I had thought if only there was a smart engineer or a smart orthopedist who could design something like this.

The iFuse procedure is really a minimally invasive alternative to an open fusion of the sacroiliac joint.  It’s a procedure that was described to me by my surgeon as taking about an hour and indeed it took an hour and five minutes from the time that I was prepared for the operating room to the time that I was awake again in the recovery room.  It’s a minimally invasive procedure that require a small skin incision, perhaps three or four centimeters, which is between an inch and a half and two inches, and then the insertion of small guiding instruments to place rigid metal inserts or implants in the joint that stabilize the joint with the idea of promoting bone growth across that joint in the coming weeks or months.  

I can do almost everything I want to do since the surgery.

I went on a long backpacking trip this summer with a 20-pound pack for 11 days…

I play basketball in the driveway with my daughters…

I bend down to get things out of the bottom cabinets. I don’t think about the joint anymore.
The kids are excited that I’m back taking them for hikes in the woods.

It sure has made a difference in how he’s able to play with the kids.  
Now he has so much more freedom to just react and just to move his body and even to be silly.

At work I have a copy of my pelvic x-ray with those three implants that are so perfectly in place and neatly aligned.  I really marvel at the surgeon’s skill in placing those implants and really what they’ve done to put my life back on track. 

I think the benefit here that I didn’t anticipate is that the anxiety and the mental energy that went into trying to figure out what this problem was, trying to keep myself together when it really was so uncomfortable.  That energy now, I’m putting it toward other things.  It’s like a cloud lifted and the fog cleared, I have a problem, I had a solution to the problem, and now I can get on with other things – and that’s of immeasurable value.  

Really whole heartedly I can’t say enough good things about what this procedure has done for me.  I think that everybody needs to have careful doctoring and a careful diagnosis and if the diagnosis is a sacroiliac joint problem I think this surgery is perfect."