Can lumbar decompression surgery make sacroiliac joint pain worse?

Doctors in Germany examined a potential connection between  lumbar decompressive surgery and new onset of sacroiliac joint-related pain causing a diagnosis of “failed-back-surgery.”

Here is what they said in their newly published research:
Patients with lumbar stenosis do have substantially positive results from decompressive surgery. HOWEVER the change of body position and walking behaviour after successful surgery might lead to changed force effects on the entire spine and on the sacroiliac joint (SIJ).

The authors analyzed the records of 100 consecutive patients from three institutions, who underwent decompressive surgery without instrumentation. The diagnosis of SIJ-related pain was confirmed by periarticular infiltration. The radiological changes of the sacroiliac joint were assessed in plain radiographs in both groups: patients with SIJ pain (group 1) and patients without SIJ pain (group 2)


  • 22 patients required medical attention due to SIJ-related pain after surgery.
  • While the walking distance increased substantially in both groups without difference, the analysis of overall satisfaction favoured group 2 patients without SIJ pain .
  • Female patients suffered more from SIJ pain after surgery.
  • Age, severity of radiological changes or number of operated segments appeared not to trigger SIJ-related pain.

The adaptation of a changed body posture and gait could lead to transient overload of the SIJ and surrounding myofascial structures.

The patients should be informed about this possible condition to avoid uncertainty, discontent, unnecessary diagnostics and to induce a quick, specific treatment.

Non-diagnosed sacroiliac joint-related pain could be a possible, but reversible reason for the diagnosis of a “failed-back-surgery”.(1)

Ross Hauser, MD covers this subject in his article Failed back surgery syndrome treatment options

1. Schomacher M, Kunhardt O, Koeppen D, Moskopp D, Kienapfel H, Kroppenstedt S, Cabraja M. Transient sacroiliac joint-related pain is a common problem following lumbar decompressive surgery without instrumentation. Clin Neurol Neurosurg. 2015 Sep 11;139:81-85. doi: 10.1016/j.clineuro.2015.09.007. [Epub ahead of print]