Dr. Don Kovalsky has been an associate of the Orthopaedic Center of Southern Illinois since 2001 and fellowship trained in Advanced Spine Surgery. He has special interest in acute and chronic conditions involving the cervical, thoracic, and lumbar spine as well as SI Joint Fusion, adult reconstructive surgery and total joint replacement.
Dr. Kovalsky is a Fellow of the American Academy of Orthopaedic Surgeons (AAOS), the North American Spine Society (NASS) and AO Spine International. His accomplishments include participating in a national study for SI Joint Fusion - iFuse Implant System [SI-Bone]; refining a surgical procedure - Anterior Lumbar Interbody Fusion utilizing allograft bone dowels; and an investigator for Synthes Spine in the use of anterior tension band plates to stabilize anterior lumbar fusions.
Dr. Kovalsky has successfully performed hundreds of SI joint fusions, and was instrumental in getting exclusive coverage by Blue Cross/Blue Shield for the procedure.
Total Disc Replacement
Dr. Kovalsky assisted in pioneering the implementation of Synthes ProDisc™-L Total Disc Replacement and ProDisk™–C Total Disk Replacement procedures. He in association with Synthes Spine, Inc. partnered to bring the latest technology in the treatment of back pain associated with disc degeneration. The researchers and engineers at Synthes Spine have developed the latest technology in disc replacement. Patients who suffer from Degenerative Disc Disease (DDD) and have tried all forms of conservative (non-surgical) treatments for the condition and are now better, now have a choice.
The traditional treatment has been spinal fusion where the unhealthy disc is removed and the bones are fixed in position and fused via bone grafts. Total disc replacement is designed to replace your unhealthy disc, resolve back/neck pain and maintain movement.
Total disc replacement is a ball and socket implant consisting of two metal endplates and one plastic inlay spacer. The plastic inlay provides the ball that rides in the socket of the upper endplate that is intended to allow motion. The Pro-Disc™-L and Pro-Disc™-C Total Disc Replacement is a new and exciting option for patients who want a choice.
Since December 2007, the Pro-Disc™-C total disc replacement has been approved for use in the United States by the FDA after an IDE clinical study.
Please visit www.synthesprodisc.com for more information on Total Disc Replacement.
SI Joint Fusion With The iFuse Implant System®
The procedure used by Dr. Kovalsky is the most common: the iFuse Implant System, developed by SI-Bone, Inc., of San Jose, California. In October 2016, he and the president of SI-Bone, as well as a few other surgeons went in front of HCSC/Blue Cross/Blue Shield Administration and medical doctors, and presented data on iFuse and the outcomes they had seen over the past eight years. They fought for their patients to get covered - and now it's exclusively covered.
The iFuse is a minimally invasive surgical option, designed to be easier and less invasive than traditional open surgical SI joint fusion. The iFuse Implant System is indicated for sacroiliac joint fusion for conditions including sacroiliac joint disruptions and degenerative sacroiliitis. The procedure typically involves three small titanium implants surgically inserted across the SI joint. It is designed to create a durable construct to stabilize the SI joint. The procedure is done through a small incision and takes about an hour. The surgeon determines the release time based upon post surgical progress and occupation. Post-operative pain is usually isolated to the incision area.
With the iFuse Implant System, there is no need for: BMP in conjunction with autologous bone graft, additional pedicle screws and rods, hollow modular anchorage screws, cannulated compression screws, threaded cages within the joint, or fracture fixation screws.
In a randomized controlled trial, 80 percent of the patients that had the iFuse procedure med the strict success criteria, and 90 percent of the patients were satisfied and would have the procedure again. Long-term pain relief and improved function have been demonstrated in three publications, sharing results up to five years.
Dr. Kovalsky is participating in a national study for SI Joint Fusion, described here.
iFuse Potential Benefits:
Less invasive than traditional open SI joint fusion surgery with no extensive soft tissue stripping
- Plus: minimal incision size (approximately 2-3 cm long) and minimal tendon irritation
- Straight forward minimally invasive surgical approach
Designed for maximum joint stability
- Triangular implant profile minimizes rotation and an interference fit minimizes micromotion
- Rigid titanium constructs provide enhanced stability
- Porous plasma spray coating
- Larger implant surface area designed to maximize post-surgical weight bearing capacity
- Biomechanically rigorous implant designed specifically to stabilize the heavily loaded SI joint
- The iFuse implant has 3X shear and 7X bending strength compared with screws1
Simplified surgical procedure with iFuse
- Pin, drill, broach, insert implants, and close
- Procedure takes about an hour
- Potential for less blood loss and reduced soft tissue stripping
The following images are of the SI Joint - iFuse Implant System
Watch video of SI Joint Fusion procedure
Mychelle's story -
Probably two to three years after spinal fusion surgery, I started having SI joint pain. Gradually over time, it worsened to almost a constant pain. It felt like a knife was sticking out of my back, especially while sitting. I was unable to site for a long time so I had trouble driving.
My boys are now 17 and 18 1/2 and my pain caused difficulty home schooling my boys when they were younger. I had to stop to take breaks adn the pain medicines would make me tired. I was unable to cook for my family because it was too painful to bend over and get the pots out of the cabinet. My pain even caused me to give up my favorite thing to do...sing on stage at my church. I went into a depression, like I had lost my best friend.
I had multiple injections and went through physical therapy. We tried many medicines - from pain meds, anti-inflammatory and muscle relaxers. They were all just band-aids. When Dr. Kovalsky mentioned that a new procedure was available, I didn't even have to think about if it was going to help. I said "sign me up"! I had both side done. There was alot of pain when I woke up but they had me walking with a walker right away. Once past recovery, the pain was alot better. Four weeks later...I was walking fine.
The surgery has really changed my life andI have been off pain medicines for one and a half years! I am always cooking for my family and able to clean house without pain. I can work out and pretty much do anything without any problems. I even singing on stage again at my church.
Larry's story -
Larry had been manager of his family owned appliance and service business since 1968. He also helped with delivery, installation and service repairs for the major appliances. In 1990 while delivering and installing an air conditioning unit, he began to feel extreme pain to his lower back, groin and down his left side of his leg. The pain immediately prevented him from bending at the waist, twisting at the torso and sitting upright.
Two days had passed and Larry was still in intense pain. His family and friends recommended Larry visit a local chiropractor who was able to provide him with some relief. "I felt better after my chiropractic visit but by the time I drove back to my house, the same terrible pain returned. Nevertheless, I continued to see him for treatments hoping the pain would eventually lessen", said Larry. Sleeping was difficult and getting in and out of his pickup truck was painful and he couldn't lift anything at all.
Larry's chiropractor recommended that he start seeing a pain doctor who prescribed pain medication. Larry experienced side effects with the medication and ended up with ulceration to his throat. Larry stopped taking the prescribed medication fearing that it would create more damage and began self-administering over the counter Ibuprofen. Larry suffered with the pain while continuing the chiropractic treatments and also had multiple pain injections.
Then in 1997 at his wits end, he began looking for more answers to help with his low back. His chiropractor provided another referral to a spine surgeon who ordered an MRI and revealed a ruptured disc at L5-S1. The surgeon performed an L5-S1 fusion with LT cages in January 1998, giving him pain relief for two months. But when Larry became active, he started to feel the same pain again. Later that year, still in pain, Larry started to feel a clicking in his left hip, like something was loose and moving around. He found a new pain doctor and started receiving more pain injections to his left side of his low back. When he had an injection to his left SI joint, he felt immediate relief, but the relief was only temporary. Even though Larry responded favorably to the injection, he didn't fully understand what his treatment options were. For another year, Larry continued to treat his SI joint pain with injections and began physical therapy.
In 2000, Larry went back to the surgeon that performed his surgery and learned that he recommended an L4-S1 Lumbar fusion with instrumentation. Larry proceeded with the surgery and recalls "this surgery took me four months to recover. It was painful and the worst part of the process was that my SI joint pain persisted. I was angry and wanted answers and went back to the surgeon to tell him the last procedure didn't work." After Larry's confrontation, the doctor told him that he might have SI joint dysfunction but offered no surgical treatment. Instead he recommended seeing a physical therapist for SI joint manipulation and strengthening.
Larry continued the physical therapy and injections until 2003 when he read about a procedure called SI joint debridement and denervation. He decided to have that procedure done and did feel some relief from his pain, but still experienced the original deep pain in his SI joint. In 2004, he went back for a repeat debridement and denervation with no successful relief at all.
Then in 2005 he read about a procedure for fixation of the SI joints with screws. He decided to have that surgery. Looking back, Larry recalls the day the SI joint screws were placed on both sides, he knew that something didn't feel right. His left SI joint continued to be painful after the surgery, with no relief, and his right side didn't bother him but it never did in the first place. Larry's physical therapist strongly urged him to return to the physician that performed the screw placements.
In 2007 Larry returned to his physician who said there was nothing wrong with the screws and that the pain he was feeling was coming from the pedicle screws and rods from a prior surgery in 2000. He offered to remove the pedicle screws and rods from L4-S1 and Larry accepted the offer and had that surgery in 2007. Larry felt some relief in his back, but the SI pain was persistent.
Larry returned to physical therapy after recovering from the instrumentation removal surgery. That's when his physical therapist insisted that it was still his SI joint that was causing the pain. He was then fitted with an SI belt to wear. The belt helped, but the pain was always there.
After 2007, Larry had no other surgeries until 2012. That's when he found out about the iFuse Implant System and contacted the nurse consultant at SI-Bone for more information. The nurse sent Larry three of the nearest surgeons who were trained in the iFuse procedure and soon Larry followed up with an appointment. The surgeon ordered a scan of Larry's left SI joint and recommended replacing the screws with the iFuse device.
On June 5, 2012 Larry's iFuse was performed and he began feeling better soon after surgery. "Finally the pain in my SI joint was gone and I was beginning to feel like my former self prior to my injury. I wish I had found iFuse earlier which may have circumvented some of my previous surgeries and years of treatment. I am just grateful that I am no longer experiencing that terrible pain".
Today, Larry is active and is enjoying his retirement. He has started to fish again, something he thoroughly enjoyed, and Larry's getting back to doing the simple things like helping do things around the house. Larry states, "I want to do my part and help others understand so they can learn from my experience".
Gayla’s story -
She complained of low back pain for several years, tried injections and physical therapy but nothing helped – Gayla just had to endure the pain. In March 2014, Gayla had the left SI joint fused and recovery was quick. She used a walker for a couple of days and a cane for one week. There was minimal soreness and she was back to work within one week of surgery. Gayla states “my back quit hurting right away and my leg wasn’t numb”. Now she is able to clean her house and work in the garden without any back pain. “For me, this was one of the best things I’ve ever done”!