Last October, at the NASS meeting in Toronto, I was fortunate to have attended a breakout session with a LENGTHY presentation on SI joint dysfunction. One of the presenters was
Dr. John Stark. This session was standing room only… I spent the first half in the doorway, struggling to listen, but I got a seat for the second half and was seated next to some researchers and doctors that I know. I know that I’m easy to impress, but discussing the SI issues with the professionals was very interesting. They were equally impressed.
The pictures he showed of the SI patients who could NOT SIT due to severe SI pain looked EXACTLY like many clients I’ve seen. The stories of spine surgery after spine surgery with no positive result, then having symptoms resolved after SI surgery were quite remarkable. Note that I don’t think that SI surgery is the be all end all treatment, but this diagnosis and treatment option may provide hope for many people who have been dismissed as psych problems, failed back surgery syndrome, etc…. Also, I hope that as ruling out this diagnoses becomes part of the protocol, some patients with SI issues can avoid unnecessary spine surgery and go straight to the problem.
It’s very interesting that many years ago, SI fusions were a common procedure that was a substantial part of the arsenal that the spine surgeons had available. They have fallen out of favor and are so far removed from the mainstream that getting a proper diagnosis for SI can be difficult or impossible. You have to run into a doctor that really knows about it and embraces the possibility. I’ve seen other diagnoses, like piriformis syndrome that even many of the surgeons I know and love, won’t take seriously.
After the session, I went out to dinner with a doctor that I’d met the previous year at NASS in Austin… Dr. George Lewinneck. (“I’m a thin verneer of Harvard Medical School under a thick layer of Wisconsin farm boy.”) His “I’m just an old country doctor, Jim” persona is very charming, but he’s a brilliant man with a very unique background. His take on Dr. Stark’s data was especially interesting because he’s been a spine surgeon long enough to have done SI fusions in the past and stopped (as had most of the industry.) He seemed to be excited about revisiting SI and also about the newer SI fusion techniques that Dr. Stark presented.
I just spent half an hour on the phone with Dr. Stark discussing some very problematic cases. I’ve very pleased to find him, as he seems to be at a place in his career where he is happy to get the difficult cases. I look forward to working with him and I’ll keep you posted as I learn more.