A Unique Cause of Sacral Radiculopathy After Minimally Invasive Sacroiliac Joint Fusion: A Case Report

New technologies for sacroiliac joint fusion (SIJF) have demonstrated improvements in pain and function. Sacral radiculopathy is a reported complication. We present a unique case of S1 radiculopathy after lateral transiliac minimally invasive SIJF. The patient provided Health Insurance Portability and Accountability Act (HIPAA)-compliant consent for the inclusion of their clinical information in this report.

A 40-year-old woman with SI joint dysfunction underwent right-sided SIJF. She reported resolution of her preoperative symptoms but developed new pain radiating to the leg. A revision procedure provided initial relief, but her pain returned. Further imaging demonstrated displaced bone, rather than a misplaced implant, causing a narrowed S1 foramen. An open S1 foraminotomy was performed to further decompress the foramen, improving symptoms, allowing her to return to her previous activity level.

This case describes a previously unrecognized cause of S1 radiculopathy after minimally invasive SI fusion and supports open foraminotomy with neuronavigation as a potential method for treatment.