This is an interesting study.  there are many causes of inguinal pain.  this is a surprising result, because the innervation level of the inguinal area is higher in the spine, such as T12-L1-L2 and this report speaks of fusions at L4-L5.  These results are surprising and are sure to provoke conversation.

Spine:  15 January 2012 - Volume 37 - Issue 2 - p
114–118  doi:  10.1097/BRS.0b013e318210e6b5
Clinical Case Series
Lumbar Disc Degeneration Induces Persistent Groin  Pain
Oikawa, Yasuhiro MD; Ohtori, Seiji MD, PhD; Koshi, Takana MD, PhD; Takaso, Masashi MD, PhD; Inoue, Gen MD, PhD; Orita, Sumihisa MD, PhD; Eguchi, Yawara MD, PhD; Ochiai, Nobuyasu MD, PhD; Kishida, Shunji MD, PhD; Kuniyoshi, Kazuki MD, PhD; Nakamura, Junichi MD, PhD; Aoki, Yasuchika MD, PhD; Ishikawa, Tetsuhiro MD; Miyagi, Masayuki MD; Arai, Gen MD; Kamoda, Hiroto MD; Suzuki, Miyako MD; Sainoh, Takeshi MD; Toyone, Tomoaki MD, PhD; Takahashi, Kazuhisa MD, PhD
Abstract
Study Design. Prospective study of 212 patients with groin pain but without low back pain.
Objective. To evaluate discogenic groin pain without low back pain or radicular pain.
Summary of Background Data. Patients feel low back pain originating from discogenic disease. It has been reported that the rat lower lumbar discs are innervated mainly by L2 dorsal root ganglion neurons. Thus, it is possible that patients feel referred groin pain corresponding to the L2 dermatome originating from intervertebral discs; however, the referred pain has not been fully clarified in humans.
Methods. We selected 5 patients with groin pain alone for investigation. The patients suffered from groin pain and showed disc degeneration only at 1 level (L4-L5 or L5-S1) on magnetic resonance imaging.
Patients did not show any hip joint abnormality on radiography or magnetic resonance imaging. To prove that their groin pain originated in degenerated intervertebral discs, we evaluated changes in groin pain after infiltration of lidocaine into hip joints and examined pain provocation on discography, pain relief by anesthetic discoblock, and finally anterior lumbar interbody fusion surgery.
Results. All patients were negative for hip joint block, positive for pain provocation on discography, and positive for pain relief by anesthetic discoblock. Furthermore, bony union was achieved 1 year after anterior interbody fusion surgery in all patients, and visual analogue scale score of groin pain was significantly improved at 1 year after surgery in all patients (P < 0.05).
Conclusion. In the current study, we diagnosed discogenic groin pain, using magnetic resonance imaging, infiltration of lidocaine into the hip joint, pain provocation on discography, pain relief by anesthetic discoblock, and lumbar surgery. It is important to consider the existence of discogenic groin pain if patients do not show low back pain.
 

Inquiry from a sacroiliac FB group:
For those of you who had surgery from Shamie, Rudolf or Kube-how are you doing? How did they handle the alignment situation prior to surgery? Did they monitor for nerve issues during surgery? Thanks much. Any other surgeons one would recommend outside the GA team. Thanks

Jerry Hesch One who turns away clients because she/he discerns that there are other issues present. Any surgeon who does not believe that magically everyone who walks in the door needs their kool aide surgery. One who educates, refers out, orders more tests when appropriate, one who stays in touch with medical literature, one who has the patient's best interest at heart, one whose Physician:Patient (I call them clients) is one of committment such
that if you have any problem, any concern after the intervention; you can get a return call in 48 hours, sooner for emergency, one who communicates with your at-home physician team, one who does not pay anyone to Facebook market him, one who does not do surreptitious private messaging marketing, one who does not say "You want to get you life back don't you?" who has the balls to stand up to any physical therapist who tries to dictate what kind of hardware to install, one who does not have a financial relationship with the Physical Therapist, nurse, PA, or kool aide stand. Who understands that joint alignment and alignment of the external landmarks: ASIS, PSIS, pubic tubercles, pubic crest, sacrum and PSIS, ischial tuberosity et al; ARE NOT ONE AND THE SAME. One who values constant continuing education as opposed to dogma, on who belongs to several professional organizations, and who refers to Physical Therapists who are members of APTA, Orthopedic Section APTA, AAOMPT, active in clincal AND research, writing and presenting, (or at least 2 of these) PT who reads Spine journals, JOSPT, PTJ, J MAnual & maniupulative Therapy, etc., etc. One whose success rates are objectively measured. Whether this surgeon and PT are  in GA as you ask or in Norfolk, or Tuscon; well worth the research. and more...

SACROILIAC FUSION ALIGNMENT???? 
I see fusion x-rays in which the vertical measurements are fairly "aligned" but the medial to lateral are NOT, and I see symphysis pubis that are NOT aligned. Please explain. Is there some
hidden research or even sound theory that states "you only have to align the vertical aspect of the ilia" prior to some form of SI fusion, but not the medial to lateral?  Not the symphysis pubis??? Separately, I have good research that indicates that you cannot use these x-rays to determine "alignment" because of something called boundary conditions, AKA frame of reference. If the person is x-rayed lying on the table a slight muscle spasm of any major lumbopelvic muscle can cause asymmetry, such that an x-ray will look like the pelvis is "mis-aligned". The SI joint might very well be perfectly aligned. I could go on and on, but the alignment mythology does not hold up to scrutiny. There is a deeper problem and yes we should optimize structure and function, but there is a vast grey zone between alignement of the pelvic bones and what happens inside the SI joints and inside the symphysis pubis. This I know, you cannot have an aligned SI fused joint and have a misaligned symphysis pubis joint (with very few exceptions). Cherry picking literature to pass out purple kool aide = $. There are more than a dozen dysfunctions that are missed with the traditional SI alignment theory. For example, lower pubic alignment; not even evaluated. Medial to lateral ischial alignment: not even evaluated in this vintage paradigm.  Anterior – to - posterior ischial alignment; not even evaluated. Oblique PSIS (mobility and) alignment, Anterior/posterior glide PSIS movement and "alignment" yadayadaya!  Apparent superior/inferior pubic alignment is not being addressed in these case series. I can help as can many others. Perhaps this new not for profit (or non-profit; 2 distinct legal entities) should work on better prevention, better screening, not proving that the grape kool aide is best. Sign me up if science is what we want.
It is what we need; not mythology. However if marketing is what is needed...Sacroiliac belief systems are quite a bit like faith based beliefs.  They are not factual in whole, much is by definition; faith based. I suggest that anyone considering SI fusion follow the protocol to the nth degree.  COMPLETELY rule out lumbar as primary, COMPLETELY RULE OUT hip as primary, etc.
The carnage is immoral. SI-Bone gets mentioned frequently, but they are the manufacturer. The responsibility of how it is applied falls in the hands of those clinicians that are allowing and encouraging these surgeries, and it is their responsibility to follow the protocol COMPLETELY.  The manufacturer cannot legislate how the individual practitioner practices. There is and has been very good care for SIJD happening all over the country as has been for decades. This new kool aide in which SIJD is POORLY DEFINED becomes a trash-can diagnosis for any, and all kinds of failed back syndrome, is dumber than goats smoking weed. 

Sign me JERRY HESCH, MHS, PT HESCH INSTITUTE accountable to the Ethiics and standards of the American Physical Therapy Association, the Nevada Association APTA, the
State of Nevada Physical Therapy licensing board, AAOMPT, etc. Call me on the carpet if I violate any of the above.

Jonathan and group 
Part of THE METHOD I use treats joint restrictions at Occiput-C1 in a very close to neutral position, using less than 10 degrees of side bending and rotation. There is very limited motion available at this joint and retesting cautiously with coupling of other upper segments will be an added measure of success. I treat everything below first, meaning below C4 to the toes, because biomechanically and reflexively C1-C2 will compensate with contralateral rotation and slight side glide. Then I treat top down, Occiput-C1, then C1-C2 if restricted, and C3 if indicated. I am referencing unilateral patterns a bilateral is another beast. Great questions you pose! Afterwards I do soft tissue work but proceeding with soft tissue work sometimes can be very helpful, less so if reflexogenic response at play. Always helpful after, and oftentimes much softer in response to the joint work.