The SI Joint
The sacroiliac joints are located in the back of the pelvis connecting the sacrum to the left and right iliac bones of the pelvis.
Before the procedure starts you will speak with Dr. Terebuh in an exam room to answer any final questions you have. He will also verify procedure safety questions. You will then be escorted to the procedure room where all the necessary equipment is located. The procedure table is a rather narrow padded surface and you will be asked to position yourself on your belly. A procedure room assistant will be present to help you if you desire.
Positioning pillows can be used to make you as comfortable as possible. The procedure table will elevate several inches and the targeted area of your spine will be sterilized with an alcohol based skin preparation that gives a cool sensation and temporarily tints your skin orange.
How to Prepare?
To get ready for your procedure please read the Preparing For Your Spine Injection page of this website.
A moving x-ray machine called a fluoroscope operated by Dr. Terebuh will be used to guide the entire procedure. The fluoroscope surrounds you like the letter “C” but it will never touch you. The fluoroscope is used to see the bone landmarks in the pelvis and increases the comfort, safety, and precision of the injection. The design of the C-arm fluoroscope allows Dr. Terebuh to get the ideal view angle to perform your procedure. The fluoroscope does deliver a dose of radiation similar to an x-ray and the machine settings can be adjusted to administer the absolute minimum radiation dose possible for your procedure. The skin over the targeted landmark will be injected with numbing medicine, which causes a very temporary sensation like a “bee sting”. Most patients agree that the numbing of the skin is the most unpleasant part of the entire procedure (fortunately it is very brief) and the rest of the process feels like movement and pressure rather than pain.
Each needle movement is verified by the fluoroscope to ensure your safety and your comfort (shown in video below). Once the needle tip is in the ideal position relative to the bone landmarks, a small amount of x-ray dye (contrast) is injected. This dye is visible on the fluoroscope and Dr. Terebuh uses it to verify that the flow of the dye goes into the sacroiliac joint and to make sure blood vessels are not carrying it away from the target. (If you have an X-ray dye allergy, this verification step with the x-ray dye cannot take place.) The final step is slowly injecting the treatment medication into the sacroiliac joint. A bandage will be applied to the injection site and you be escorted back to the original exam room for the after injection observation, monitoring, and discharge process.
Sacroiliac Joint Steroid Injection
Anatomy of the Spine