Surgical procedure used to treat chronic pain arising from the sacroiliac joint. The procedure stabilizes the joint by placing implants across the SI joint, reducing abnormal motion and allowing the bones to fuse together over time.
Quick Facts:
- Treats pain originating from the sacroiliac joint
- Stabilizes the SI joint and reduces painful motion
- Typically performed through a minimally invasive approach
- Often considered after failure of conservative treatment
👉 Request an Appointment
👉 Refer a Patient
👉 SI Joint Fusion Surgical Information Packet
WHAT IS SI JOINT FUSION?
The sacroiliac joints connect the sacrum (base of the spine) to the pelvis. These joints help transfer forces between the upper body and the legs.
SI joint fusion is a procedure that stabilizes the sacroiliac joint by placing implants across the joint and encouraging the bones to fuse together.
The procedure involves:
- Accessing the SI joint through a small incision
- Preparing the joint for fusion
- Placing implants across the joint
- Stabilizing the joint while fusion develops
👉 The goal is to reduce painful motion and provide long-term stability.
WHY IS SI JOINT FUSION PERFORMED?
SI joint fusion is performed when the sacroiliac joint is determined to be a significant source of pain and non-surgical treatments have not provided lasting relief.
Common Indications
- Sacroiliac joint dysfunction
- Chronic low back pain arising from the SI joint
- Degenerative SI joint disease
- SI joint instability
- Persistent pain following lumbar fusion surgery
- Failure of conservative treatment
👉 Accurate diagnosis is critical because many conditions can cause symptoms similar to SI joint pain.
SYMPTOMS THAT MAY REQUIRE SI JOINT FUSION
Common Symptoms
- Pain in the lower back
- Pain near the buttock
- Pain over one side of the pelvis
- Groin pain
- Pain that worsens with standing, walking, or transitioning from sitting to standing
Typical Pattern
- Pain is often located below the beltline
- Symptoms may mimic lumbar spine pathology
- Pain may worsen with prolonged standing, walking, climbing stairs, or getting out of a car
🚨 Other Conditions May Cause Similar Symptoms
- Lumbar disc herniation
- Lumbar spinal stenosis
- Hip arthritis
- Sacral fractures
- Peripheral nerve disorders
HOW IS THE PROCEDURE PERFORMED?
Step-by-Step Overview
Anesthesia
- Performed under general anesthesia
Minimally Invasive Approach
- A small incision is made over the buttock region
Joint Preparation
- The SI joint is identified using imaging guidance
- The joint is prepared to promote fusion
Implant Placement
- Specialized implants are placed across the SI joint
- Implant position is confirmed using intraoperative imaging
Closure
- The incision is closed and dressings are applied
OUR APPROACH
Successful SI joint fusion begins with establishing the correct diagnosis.
We carefully evaluate:
- Symptom location and pattern
- Physical examination findings
- MRI and imaging studies
- Response to diagnostic SI joint injections
- Other potential pain generators
Because SI joint pain can closely resemble lumbar spine disorders, we focus heavily on diagnostic accuracy before recommending surgery.
👉 Our goal is to ensure the SI joint is truly the source of pain before proceeding with fusion.
WHAT TO EXPECT
Before Surgery
- Clinical evaluation and physical examination
- Imaging studies
- Diagnostic SI joint injections
- Review of prior treatments
Day of Surgery
- Performed under general anesthesia
- Typically performed through a small incision
- Often performed as an outpatient procedure
After Surgery
- Walking begins shortly after surgery
- Temporary activity restrictions may be recommended
- Gradual increase in activity over time
- Fusion develops over several months
OUTCOMES & RISKS
Potential Benefits
- Reduced SI joint pain
- Improved stability
- Improved ability to stand and walk
- Reduced reliance on pain medications
- Improved quality of life
Risks
- Infection
- Bleeding
- Nerve injury
- Persistent pain
- Failure of fusion
- Implant loosening
- Implant malposition
- Need for additional surgery
👉 Outcomes are generally best when the SI joint has been clearly identified as the primary pain source.
FREQUENTLY ASKED QUESTIONS
How do you know my pain is coming from the SI joint?
Diagnosis is based on symptoms, physical examination findings, imaging studies, and response to diagnostic SI joint injections.
How is SI joint pain different from sciatica?
SI joint pain often occurs in the lower back, buttock, or pelvis, while sciatica typically follows the course of a nerve down the leg.
Will I need to stay overnight?
Many SI joint fusion procedures are performed on an outpatient basis, although this varies between patients.
How long does fusion take?
Fusion develops gradually over several months.
Will the implants stay in permanently?
Yes. The implants are intended to remain in place permanently and support long-term fusion.
FOR REFERRING PHYSICIANS
Refer patients with:
- Suspected SI joint dysfunction
- Chronic low back pain below the beltline
- Buttock pain
- Persistent pain after lumbar fusion
- Positive response to diagnostic SI joint injections
Imaging:
- MRI lumbar spine when indicated
- Pelvic imaging when appropriate
- CT scan in selected cases
Consider:
- Diagnostic SI joint injections
- Exclusion of lumbar pathology
- Exclusion of hip pathology
- Confirmation of SI joint pain generator
RELATED CONDITIONS / PROCEDURES
- Sacroiliac Joint Dysfunction
- Chronic Low Back Pain
- Lumbar Fusion
- Adjacent Segment Disease
- Degenerative Disc Disease