A New Surgical Option for Low Back Pain

Jennifer Guidry, 36, was at the end of her rope when she traveled to Yale from outside Boston to be evaluated for a clinical trial in early 2014. In 2000, while serving in the Navy, she injured her back. At first she had intermittent pain, but over the years her condition deteriorated to the point where she couldn’t work and needed a cane and a wheelchair to get around.

After trying a host of treatments that included physical therapy, electrical nerve stimulation, pain medications, steroid injections, radiofrequency ablation, acupuncture, and chiropracty, her doctor told her she would have to use narcotics and learn to manage her pain. “My life was basically over,” she said.

Dissatisfied with her situation, she combed the medical literature in an attempt to find a way to treat her condition, which was caused by an injury to her sacroiliac (SI) joint. Pain due to SI joint disorders can occur on one or both sides of the low back, the groin, the hip, thigh, buttocks and down the back of the leg. SI joint disorders can be easily misdiagnosed because the symptoms are similar to other conditions such as a herniated disc or sciatica. “SI-mediated pain is really a condition that has more recently been recognized as a source of back and buttock pain,” said orthopaedic surgeon Peter G.Whang, MD, FACS.

Jenn found a clinical trial being conducted at Yale to test how well a new FDA-approved surgical procedure to treat SI joint disorders works compared to non-operative care.  “The fact that it was Yale made a difference,” she said. “I felt like that gave it more legitimacy.” The minimally invasive procedure involved placing three specially coated implants across the SI joint to eliminate motion. “The advantage of doing it less invasively is that patients recover from surgery much more quickly because there’s not as much damage to the surrounding muscle and soft tissues,” said Dr. Whang, who led the study. Special imaging techniques allow Dr. Whang to avoid making a large incision.  “The advantage of doing it less invasively is that patients recover from surgery much more quickly because there’s not as much damage to the surrounding muscle and soft tissues,” he said.

When she arrived at Yale for the first study visit, Jenn couldn’t stand at the reception desk long enough to sign in. When she woke up from surgery, the pain was instantly better. “That aching, grinding, unstable feeling was gone,” she said. She went home the next morning and rapidly gained mobility. By two weeks post-surgery, she was ready to give up her cane.

Today, Jenn is working and enjoying life. Her three children had always seen her as someone in pain who couldn’t participate in their activities. Now they are amazed that she can keep up with them. Not long ago, she took her kids to the movies. It was raining, so she began to jog, something she hadn’t been able to do for 14 years. “I was beaming and crying at the same time,” she said. “It’s those tiny little things that hit home time and time again.”

“I had already been doing conservative treatment for 14 years so I already knew it wasn’t very effective. The research showed that the risks were low and the benefits were possible.”