A couple of Chiropractic practice relevant takeaways from the Duke Spine Symposium this morning on SIJ fusion by Dr. Grossi:
~SIJ lower extremity pain referral can mimic radicular or facet referral patterns.
~SIJ fusion is not as effective as other fusion surgery in other joints because there’s little movement in the SIJ to start with. The goal is more stabilization.
~Many recidivistic SIJ pain syndromes result from adjacent segment pathology or surgery (i.e. lumbar fusion and hip prosthesis) that increases compensatory forces into the SIJ.~The key diagnostic criteria are based on the patient’s presentation & symptoms, and CT guided SIJ injection block.
~While he didn’t specifically include chiropractic care as part the treatment algorithm, in the Q&A portion he spoke very positively about chiropractic care, he refers to several DC’s, and gets many referrals from DC’s. He spoke favorably about the value of manipulation and how adding chiropractic care helps patients avoid surgery.
~I thought it was refreshingly candid that he:
~ mentioned that reimbursement considerations figure into the decision on what techniques to use or not use.
~ revealed his performance stats, bad outcomes, and mitigation strategies.