SI Joint Fusion
The sacroiliac (SI) joint connects the sacrum (the triangular bone at the base of the spine) to the iliac bones of the pelvis. SI joint dysfunction is an under-recognized but common cause of low back, buttock, and sometimes leg pain — accounting for 15–30% of chronic low back pain cases.
When SI joint injections provide only temporary relief, or when SI joint dysfunction is confirmed to be the primary pain driver, minimally invasive SI joint fusion offers a long-term solution.
When Is SI Joint Fusion Appropriate?
SI joint fusion is considered when:
- SI joint pain is confirmed by positive diagnostic SI joint injections
- Conservative treatment (physical therapy, injections) has provided only temporary relief
- SI joint instability or degeneration is present on imaging
- Quality of life is significantly affected by SI joint pain
The Minimally Invasive Procedure
Modern SI joint fusion uses a small lateral approach — no large incision. Through a 2–3 cm incision over the side of the hip, specialized triangular titanium implants are placed across the SI joint under fluoroscopic guidance. These implants stabilize the joint and promote bone fusion over time.
The procedure takes about 1 hour under general or spinal anesthesia and is typically performed as an outpatient or with overnight observation.
Recovery
- Weight-bearing with a walker or crutches for the first 2–4 weeks
- Gradual return to normal activities over 6–8 weeks
- Bone fusion typically confirmed on CT scan at 6 months
Results
Multiple randomized controlled trials demonstrate that minimally invasive SI joint fusion provides superior and durable pain relief compared to continued non-surgical management. The majority of patients report significant improvement in pain and function at 2-year follow-up.
Frequently Asked Questions
Is this a major surgery? No. Minimally invasive SI joint fusion uses small implants through a tiny incision — it is far less invasive than traditional open spinal fusion procedures.
Does insurance cover SI joint fusion? Medicare and most commercial insurance plans cover SI joint fusion when appropriate diagnostic criteria are met, including documented positive SI joint diagnostic injections.
Contact Us
Call 516-492-3100 to discuss whether SI joint fusion is appropriate for your chronic low back and pelvic pain.