How does a woman go in for spinal fusion surgery and come home with pelvic pain?

Platelet rich plasma injections for meniscus tears

Ross Hauser, MD and Katherine L. Worsnick, MPAS, PA-C

Our website contains many articles on the problems of undiagnosed damaged or injured spinal and pelvic ligaments causing low back and sacroiliac pain. In this article, we will discuss the problems of women who underwent spinal fusion and came home with pelvic pain.

How does a woman go in for spinal fusion surgery and come home with pelvic pain?

One answer is that the pelvic pain was there all along, it was mistaken for low back pain because an MRI gave evidence of degenerative disc disease and Sacroiliac joint dysfunction. The fact that the patients came home with pain is an indication that the surgery did not treat what was causing the pain.

This is a complex subject and worthy of deep analysis. Please see Surgery for degenerative disc disease? Researchers say many are unnecessary and make patients worse.

The investigation into finding the true source of the woman’s low back pain – Spinal instability and pelvic instability can look exactly the same.

Spinal instability and pelvic instability are the main causes of most low back and pelvic pain. Various researchers have documented the common symptoms of clinical spinal instability and pelvic instability as:

Back surgery for pelvic pain is wrong

Dr. Bo Nystrom is a doctor whose research we often cite. In July of 2017 he lead a study published in the Scandinavian journal of pain of the clinical outcome following anterior arthrodesis (spinal fusion) in patients with presumed sacroiliac joint pain.(1) In this study, the problems of continued or worsening pelvic pain in women treated with a spinal fusion is what caught our attention.

Here are the findings of that research in 55 women.

At follow-up:

A successful spinal fusion causing more pain? Where did all this pain come from? Spinal and Pelvic Ligaments

Here is the researchers concluding statement: “We speculate that continued pain despite a healed arthrodesis (fusion) may be due to persistent pain from adjacent ligaments. The next step should be a prospective randomized study comparing posterior fusion and ligament resection with non-surgical treatment.”

As a Prolotherapist, what more can you say? Here we had a successful spinal fusion causing more pain. Why?  Persistent pain from adjacent ligaments, we have seen it here, adjacent segment disease stressing the spinal ligaments and the surgery itself causing damage to the ligaments leading to post-spinal instability. In the research above these problems translated to pelvic pain in 45% or so women who had a spinal fusion.

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Danielle Steilen-Matias, PA-C | Katherine Worsnick, PA-C | Ross Hauser, MD | David Woznica, MD

1 Nyström B, Gregebo B, Taube A, Almgren SO, Schillberg B, Zhu Y. Clinical outcome following anterior arthrodesis in patients with presumed sacroiliac joint pain. Scandinavian Journal of Pain. 2017 Oct 1;17:22-9.

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