NADIA

Neurovascular Anticipating Distraction Interference Arthrodesis

The Problem

The sacroiliac joint experiences subtle deformity as it undergoes degeneration and reactive change. The primary bone and joint changes of subluxation, osteophyte formation, and capsular distension often cause irritation of the overlying lumbar plexus. This results in symptoms that closely resemble lumbar disc-related radiculopathy. Correction of the deformity by bridging arthrodesis methods may address some components of the nerve encroachment.

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Anatomical Features

The complex anatomy surrounding the SIJ is amenable to the proper surgical approach. For this reason, Ilion's posterior technique avoids the neurovascular structures. It approaches the sacroiliac articulation within the safety of the recess and exits into the safety of the bony pelvic anterior column. The posterior approach never crosses the paths of critical nerves or vessels. Safety is planned into every step.

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Surgery and healing conditions

Posterior implants serve a bridging function; they are not by themselves a fusion method or true fixation. Once placed they are secure but bone healing is required. A full consideration of endocrine, metabolic, or nutritional deficiencies will maximize the chance of true bone fusion.

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Challenging Treatment

A reliable, safe SIJ fusion method fulfills an important need in orthopedic surgery. The treating professional and the patient should explore other possible diagnoses within the region of the hip and spine. Treatment of any of these individual structures requires a full understanding of the diagnosis and all respective treatment options. Surgical treatment of the sacroiliac joint is a worthy challenge for any spine surgeon.

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