What is SI joint fusion?

The sacroiliac joint, or SI joint, is a common cause of lower back pain. SI Joint Fusion is the standard surgery used to address SI joint pain. The goal of this minimally invasive procedure is to provide pain relief by limiting motion that will cause more joint pain.

Located in the pelvis, the SI joint links the iliac bones in the pelvis to the sacrum, which is the lowest portion of the spine above the tailbone. The SI joint is important for shock absorption and preventing impact on the spine. The SI joint can be injured or experience wear and tear due to aging. This can cause people to experience pain in their buttocks, low back, or legs.

The SI joint fusion corrects this issue by inserting implants across the joint. Once in place, the implants prevent motion that causes more SI joint pain. 

Those that deal with SI joint dysfunction are familiar with the impact it can have on everyday life. You may experience not only pain, but difficulty functioning and even sleeping. Once the implants are in place and the recovery process is started, you can expect a reduction in symptoms, which will allow you to more fully enjoy everyday life without worrying about painful symptoms.

How to know if you need surgery

You may consider SI joint fusion if you are experiencing SI joint pain and non-surgical treatments have failed. You will first need to identify that your SI joint is the source of your pain. To do this, a physical examination and tests may be required. Your physician will consider the information you provide along with the location of your pain, history of injury, and other issues you’re having.

During the examination, you may be asked to stand or move in different positions. Imaging tests, such as X-ray, CT, or MRI may also be used to assist in the diagnosis.

Additionally, there is an SI joint injection that may be used to confirm the source of the pain. For this procedure, the SI joint is injected with a local anesthetic. The injection is given under X-ray or CT to ensure the needle is properly placed in the SI joint. Your pain level will then be monitored after the injection. If you experience a significant reduction in pain, your SI joint is likely the cause of your pain. If your pain level does not change after the injection, it’s unlikely that your SI joint is the cause of your pain.

SI joint dysfunction may include the following symptoms. If you are experiencing any of these symptoms, make sure you consult with your doctor:

  • Lower back pain
  • Pelvis/buttock pain
  • Hip/groin pain
  • Pain, numbness, tingling, weakness in lower extremity
  • Pain when moving from sitting to standing
  • Instability in legs
  • Disturbed sleep patterns due to pain
  • Disturbed sitting patterns (unable to sit for long periods or sitting on one side)

What are the benefits of SI joint fusion?

SI joint fusion is a minimally invasive procedure that only takes about an hour to perform. Once the implants are in place, it prevents SI joint pain by minimizing rotation and micromotion. Thanks to the porous titanium surface, bone growth onto and into the implants is also possible.

The procedure has been found successful at providing quick and long-lasting pain relief. Most patients are satisfied with the long-term results of the procedure, with 73% experiencing a reduction in pain.

What are the risks of SI joint fusion?

While the procedure is often successful, any surgery involves some level of risk. Possible risks include:

  • Bleeding
  • Infection
  • Increased pain
  • Allergic reaction to the implants
  • Migration, loosening, or breaking of the implants

Another risk to consider with the procedure is the possibility that it won’t alleviate pain, or that fusion of the joint will be unsuccessful. If the bones do not fuse together, it could cause instability and pain. It’s also possible that the fused SI joint will cause pressure in the lower spine instead of the pelvis, which is where the pressure would normally be absorbed. This pressure on the spine could cause pain and pressure in the lower back.

Important considerations prior to proceeding with surgery

You will need to be evaluated and diagnosed by a physician to determine that you are experiencing SI joint pain. SI joint fusion is recommended if non-surgical treatments have been tried and deemed ineffective. These non-surgical treatments are usually tried over the course of several months before surgery is advised. You should also consult carefully with your surgeon before deciding to have the procedure.

It’s important to develop a postoperative plan with your surgeon and other healthcare providers, such as your physical therapist.

The procedure is not recommended for patients who are allergic to certain metals, have tumors, or have active infections in or around the SI joint. Certain types of fractures in the pelvis should be taken into consideration as well as those may need to be treated before surgery.

What is the recovery process after SI joint fusion surgery?

SI joint fusion is a minimally invasive procedure that begins with a small incision made over the lower back. The surgeon will then carefully move muscles to the side and use a device to drill a small hole through the ilium and access the joint. After the joint is cleared of ligaments and muscles, they will put the bone graft in place. They will then put the muscles back in place and close the surgical site. This process should take about an hour.

After the procedure is complete, a hospital stay of one to two nights may also be recommended. Recovery from the procedure may include pain medications, physical therapy, and applying heat and ice. You will also not be able to put weight on the operated side and must use crutches for several weeks. A pelvic brace may also be required to stabilize the pelvis and limit movements. Overall, the recovery period is usually between 3 and 6 months.

Learn more about this procedure and find out if it’s right for you by clicking on the button below to request an appointment with one of our providers to discuss this procedure or other techniques that might offer pain relief.

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