Minimally invasive sacroiliac (SI) joint stabilization

Overview

Your sacroiliac (SI) joints connect the base of your spine to your pelvis. When one of these joints is worn, loose or inflamed, it can cause ongoing pain in the low back, buttock or hip. Many people improve with therapy, a belt, injections or radiofrequency treatment.

For some people whose pain continues, minimally invasive SI joint stabilization may help. Through a small incision, 2 to 3 titanium screws are placed across the joint to hold it steady. All GSMC providers evaluate patients and help decide who may be a good fit.

What it is

Stabilization means holding the SI joint steady so it moves less, which may ease pain that comes from extra motion in the joint. GSMC uses the CornerLoc™ SI joint system with a posterolateral approach: the screws are placed from the back, angled toward the joint.

• 2 to 3 titanium screws are placed at right angles to the SI joint, passing from the ilium (pelvis) across the joint into the sacrum.
• According to the manufacturer, this angled path is designed to avoid the gluteal (buttock) muscles, artery and nerves that a straight side approach would pass near.
• The screws are meant to steady the joint right away. Healing around the screws continues over the following months.

Who it's for

SI joint stabilization may be considered for people who have:

• Ongoing low back, buttock or hip pain from the SI joint
• Exam tests that point to the SI joint
• Clear short-term relief from a diagnostic SI joint injection
• Pain that has not improved after about six months of conservative care, such as therapy, medicines and injections

What the procedure involves, step by step

1. Confirming the source: we confirm the SI joint is the pain source with an exam, imaging and usually a diagnostic SI joint injection.
2. Before the procedure: we review your health, medicines and allergies. Blood thinners may need to be paused, but only with approval from the doctor who prescribes them.
3. Getting ready: you lie face down and receive sedation or anesthesia. The skin is cleaned and numbed.
4. Guidance: live X-ray (fluoroscopy) is used to find the SI joint and guide every step.
5. Small incision: a small incision is made in the lower back or buttock area.
6. Screws: 2 to 3 titanium screws are placed across the joint, from the ilium into the sacrum, using the posterolateral approach.
7. Going home: the incision is closed and covered. Many people go home the same day after a period of monitoring.

Recovery and what to expect

• Soreness at the incision is common for the first several days. Keep it clean and dry as instructed.
• You may limit weight on the treated side for a period, sometimes with crutches or a walker.
• Physical therapy helps you return to activity step by step over the following weeks.
• Follow-up visits check your progress and your written activity plan.

Candidacy: who may or may not be a good fit

May be a good fit: people with confirmed SI joint pain that has not improved with about six months of conservative care.

May not be a good fit: people whose pain comes mainly from another source (such as the hip or lumbar spine), people with an active infection, a tumor or fracture in the area, severe osteoporosis, a metal allergy, or health problems that make sedation or anesthesia unsafe. Pregnancy is also a reason to wait.

Risks in brief

Every procedure has risks. These include infection, bleeding or bruising, nerve irritation, a screw that does not sit as planned, ongoing pain and, rarely, the need for another procedure. Sedation or anesthesia also carries risks. Our team will review your specific risks with you.

Alternatives

Other options may include physical therapy, an SI belt, medicines, SI joint injections and radiofrequency ablation of the nerves to the SI joint. You can also ask for a second opinion.

SI Joint Stabilization patient brochure (print-ready PDF)

Our 4-page guide covers the SI joint, symptoms, diagnosis, options to try first, minimally invasive SI joint stabilization with 2 to 3 titanium screws placed with the CornerLoc™ system and its posterolateral approach, recovery, risks and insurance. All GSMC providers evaluate patients and help select who may be a good fit.

Print at home/office (Letter) Print shop version (with bleed)

CornerLoc™ is a trademark of Foundation Fusion Solutions, LLC (dba CornerLoc). GSMC is not affiliated with the manufacturer.

Frequently asked questions

Insurance

GSMC participates with all Aetna plans, including Aetna HMO, and with many other insurance plans. Coverage for a specific procedure depends on your plan and may need prior authorization; call 732-202-3000 to verify. Our team can help check your benefits before treatment.

See accepted insurance

Related pages

Related conditions

• SI joint dysfunction
• Low Back Pain
• Back Pain

Related treatments and resources

• SI joint injection
• Radiofrequency ablation
• SI Joint Stabilization brochure (PDF)