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Have pain in sacroiliac joint, L5 and L6 joints. What cure should be done?

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Orthopaedic Surgeon
Practicing since : 1975
Answered : 72 Questions

I am 51yo Australian male. I was in a car accident when I was 16yo and slammed my left hip into the roof of the car after having been flipped over. I have had serious back issue since the accident, mainly in the sacroiliac joint and the L5 and L6 joints because of spondylothesis..

I find it intensely painful sleeping on my left side as it pulls the left 'wing' of the pelvis forward thus putting pressure on the Sacroiliac joint. I think this injury was overlooked in the accident triage and has become worse over time.

Is there anything that can be done with this type of injury? How should i go about getting it assessed? I have contemplated a laminectomy for the spondylothesis but what about the joint? Can the joint be replaced?

What do you recommend on how I go about getting it assessed?
Mon, 17 Dec 2012 in Bones, Muscles and Joints
Answered by Dr. Rajesh Gajwani 2 hours later

Thanks for your query.

After reading your symptoms I feel that before we decide on the surgical aspect, we need to get certain investigations done for a definitive diagnosis such as MRI of sacroiliac joint and lumbosacral joint. Has it been done before?

Before you decide to go ahead with laminectomy, I would recommend you to try physiotherapy, yoga and hot fomentation, as the results have been effective to an extent for relief in both the joints.
According to studies, surgery of sacroiliac joint may not be of much help in the long term.

I would strongly recommend you to visit an orthopedic surgeon along with a neurosurgeon for a complete examination with diagnostics. You could get the process of treatment started under their able guidance.

Hope this answers your queries. If you have any more queries, do let me know.

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Follow-up: Have pain in sacroiliac joint, L5 and L6 joints. What cure should be done? 28 hours later
I appreciate the response and will take your suggestions and act on them. I have lived with this for too long and am looking for a permanent fix. I'm pretty sick of the pain, lack of sleep and effect on my IT career because of these issues.

However, you didn't answer my questions about whether these joints can actually be replaced/repaired.

I understand the first response is to avoid the knife; that's responsible advice, but I think I'm beyond that.
Answered by Dr. Rajesh Gajwani 7 hours later

Thanks again for following up.

As far as surgery is concerned, laminectomy for spondylolysthesis can be done for L5-L6 joints with predictable results. Sacroilliac joint can be operated however the long term results of sacroiliac joint surgery are not predictable.

I will be able to discuss further and provide you a more informed opinion if you can send me the latest diagnostic report (MRI of the above joints). You can upload the report using the site's uploader (available on this page) or send it to my attention (Attn: Dr. Rajesh Gajwani) and post it to YYYY@YYYY

Awaiting your response...

Above answer was peer-reviewed by
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