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Format: 04/24/2014
Format: 04/24/2014


Somerset Daily American: Stoystown woman finds relief from back pain

Wednesday, November 4th, 2009

By Vicki Rock

Daily American Staff Writer

Phyllis Ohler has had debilitating back pain for 15 years.

“I was barely able to work,” the 54-year-old Stoystown woman said. “I have degenerative disc disease. I don’t know why I have it.”

After several procedures that didn’t give her relief, neurologist Dr. Oliver Smith referred her to the Institute for Pain Medicine at West Penn Hospital in Pittsburgh.

She had a sacroiliac nerve rhizotomy, said Dr. Jack Kabazie, medical and program director for the institute.

The sacroiliac joint is located between the sacrum at the base of the spine (commonly called the tailbone) and the ilium (the curved bone) of the pelvis. First, the physician does an examination to determine that it is a dysfunction of the sacroiliac joint causing the back pain.

“About 30 percent of people who have back pain have this problem — the tests point us in that direction,” Kabazie said.

The physician injects a local anesthesia into the joint, followed by a radio-opaque dye with a steroid in case there is inflammation. If the pain goes away and doesn’t return, then it was an inflammation, he said. If the pain goes away, but returns, then it is dysfunction of the sacroiliac joint.

For treatment, physicians perform a rhizotomy. The patient is sedated. The physician inserts an electrode into the sacroiliac joint. Radio frequency waves heat the electrode. The procedure deadens the nerve branches surrounding the joint.

Previously, the procedure was done with a long, straight needle. In the past year, the institute has switched to a curved needle designed specifically to meet the contours of that joint. The physicians use fluoroscopic guidance to watch the procedure on a TV screen to make sure the needle is being inserted correctly.

“Inserting the needle is what takes the time,” Kabazie said. “Once the needle is in, it only takes eight minutes. The total procedure takes 30 to 45 minutes. This procedure should provide relief for years at a time for patients who have been living in excruciating pain.”

Ohler had several rhizotomies before, but they were done on the lumbar facet joint. Since her pain seemed to be in the hip, Kabazie did the test for the sacroiliac joint.

“Thank God I had it done,” Ohler said. “It took about two weeks for the pain to ease — it eased some each day. It brought my pain level from a 9 to a 2. It gave me my life back.”

To read more, visit the Daily American web site.

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