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Sacroiliac (SI) Joint Fusion

Treatments

About SI Joint Pain

Overview:

The sacroiliac joints (SI) are the foundation of the spine and are located at the junctions of the sacrum and ilium on each side. These complex joints, transmit the forces exerted through the spine from the upper body to the legs. The SI joint is designed to absorb shock forces and is naturally constrained to only limited movement. Dysfunction in the SI joint is a major pain generator in some patients.

Sacroiliac Joint Diagram

Symptoms:

As with other joints in the body, the SI joint can become damaged, can suffer from wear and tear, or the ligaments supporting the joint may be stretched or injured.

  • Low back pain
  • Pelvis/buttock pain
  • Lower extremity pain
  • Hip/groin pain
  • Problems sitting, sleeping, or walking

Diagnosis:

Accurate diagnosis is crucial for effective treatment. Your orthopaedic spine surgeon may use a combination of clinical evaluation, medical history, imaging studies, and diagnostic injections to pinpoint the source of SI joint pain.

Sacroiliac Joint Pain Symptoms

Treatment:

Before considering surgical treatments, conservative approaches are often recommended:

  • Anti-inflammatory medications
  • Physical Therapy
  • Chiropractic Care
  • Pain Management Intervention:
    • Medications
    • Therapeutic Injections
    • Radiofrequency Ablation (RFA)(when covered by insurance)
    • SI Joint Stabilization or Fusion

About Minimally Invasive SI Joint Fusion

Overview:

Your doctor may recommend either a Sacroiliac (SI) joint stabilization or a SI joint fusion as a permanent solution to your pain or when other conservative treatments have failed. Both stabilization and fusions, are surgical procedures performed in an outpatient surgical center. They are minimally invasive surgical (MIS) procedures performed under either conscious sedation or general anesthesia. This procedure aims to stabilize the SI joint, providing lasting relief from pain and improving overall function.

SI Joint Stabilization

SI joint stabilization is a procedure designed to decrease the painful movement in the SI joint by grafting the sacrum to the ilium using a bone graft. The entire procedure is done through a single, one inch incision on the patient’s upper buttock. The bone graft, which is about the size of an almond, is wedged into the SI joint to restrict painful movement. Over time, bone will grow in and around the graft forming a bone bridge connecting the sacrum to the ilium. The whole MIS SI joint procedure takes about a half hour, and recovery time is significantly less than open surgery.

SI Joint Fusion

SI joint fusion is a procedure designed to decrease the painful movement in the SI joint by fusing the sacrum to the ilium using titanium screws. The entire procedure is done through a single, two-inch incision on the side of the patient’s buttock. Typically, two to three small (about 1.5 in long) surgical screws are used in a fusion procedure. The whole MIS SI joint procedure takes about a half hour, and recovery time is significantly less than open surgery.

What to Expect:

Day of Procedure:

  • Preparation: You will receive detailed instructions on pre-procedure preparations.
  • Anesthesia: Typically performed under general anesthesia or conscious sedation.
  • Procedure: Minimally invasive techniques involve small incisions, reducing tissue damage.
  • Implant Placement: Specialized implants are used to stabilize the SI joint.

After the Procedure:

Patients leave the surgery center the same day, shortly after surgery and can usually resume daily living activities within a couple of weeks, depending on how well they are healing and based on physician’s orders. Most patients report a significant and lasting reduction of their pre-operative SI joint pain following recovery from SI joint fusion procedures.

Your specific recovery guidelines will be provided by your physician. Recovery times may vary by patient.

Expected Results of SI Fusion:

Patients undergoing SI joint fusion can anticipate several positive outcomes:

  • Pain Reduction: SI joint fusion is designed to alleviate or significantly reduce pain arising from SI joint dysfunction.
  • Improved Stability: The procedure stabilizes the SI joint, enhancing overall pelvic and lower back stability.
  • Enhanced Functionality: Many patients experience improved mobility and functionality after the fusion, allowing for a more active lifestyle.
  • Long-Term Relief: SI joint fusion aims to provide lasting relief, reducing the need for ongoing pain management.

It's crucial to note that individual results may vary, and the success of SI joint fusion depends on various factors, including the patient's overall health and adherence to postoperative care instructions. Your orthopaedic spine surgeon will discuss realistic expectations based on your specific case during the preoperative consultations.

Patients should actively engage in postoperative rehabilitation and follow their surgeon's guidance for optimal results. SI joint fusion can be a transformative solution for those struggling with chronic SI joint pain, offering the potential for a more comfortable and fulfilling life.

Recovery from SI Joint Procedure