http://www.youtube.com/edit?o=U&video_id=haZrk2_UEUM
Jerry Hesch This is an important case in which an SI support applied up high was not tolerated and the sacroiliac experts she consulted did NOT evaluate the stability of her pubic joint (symphysis pubis). She was given a standard diagnosis at a sacroiliac clinic of "Right Posterior Ilium with Upslip....." based on three gross movement tests that do not isolate the sacroiliac joint. Severe disc disease is present and MUST be given consideration. To suggest that fusing her sacroiliac joints alone in the presence of pubic joint instability and severe lumosacral disc disease requires a significant level of evidence. In February I presented the research evidence for surgical stabilization of the pubic joint (objective proof of separation) which in turn will stabilize the sacroiliac joint, unless the sacrospinous and sacrotuberous ligaments are torn. This at APTA CSM 2014. The evidence is in the published research. Conservative cases with pubic joint hypermobility, mild to moderate instability can heal with conservative measures for example a pubic joint support, NOT a sacroiliac support. This is a complex topic and I cannot do justice here.
Jerry Hesch This is an important case in which an SI support applied up high was not tolerated and the sacroiliac experts she consulted did NOT evaluate the stability of her pubic joint (symphysis pubis). She was given a standard diagnosis at a sacroiliac clinic of "Right Posterior Ilium with Upslip....." based on three gross movement tests that do not isolate the sacroiliac joint. Severe disc disease is present and MUST be given consideration. To suggest that fusing her sacroiliac joints alone in the presence of pubic joint instability and severe lumosacral disc disease requires a significant level of evidence. In February I presented the research evidence for surgical stabilization of the pubic joint (objective proof of separation) which in turn will stabilize the sacroiliac joint, unless the sacrospinous and sacrotuberous ligaments are torn. This at APTA CSM 2014. The evidence is in the published research. Conservative cases with pubic joint hypermobility, mild to moderate instability can heal with conservative measures for example a pubic joint support, NOT a sacroiliac support. This is a complex topic and I cannot do justice here.
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