SI Joint Fusion

Sacroiliac Joint Fusion

What is SI Joint Fusion?

In an SI Joint Fusion, bone growth over the sacroiliac joint is encouraged with use of a titanium rod or compression screws, or by a bone graft. By fusing the bone around the SI joint, this immobilizes the joint and removes any movement, effectively creating a major reduction in pain and inflammation.

Minimally Invasive vs. Traditional SI Joint Fusion

At Inspired Spine, a minimally invasive SI joint fusion procedure generally takes 30-40 minutes to complete. You will go under general anesthesia for the procedure, which is safe and effective. A small incision, less than an inch, is made to access the SI joint. Using specialized instruments, the sacrum and pelvis are fused to ensure enough stability to support the spine. This will stop chronic inflammation which removes irritation from surrounding nerves, so typically, the leg pain goes away as well after the procedure.

This procedure also avoids the necessity of bone harvesting, hence preserving both bone and ligaments. Our spinal fusion procedures aim to stabilize the SI joint(s) to be strong enough for activities such as standing, walking, and running.

Traditional SI joint fusion surgery involves an incision 7-8 inches long, opening muscle and tissue to get the SI joint, removing cartilage and taking a piece of the pelvic bone, then grafting it to the joint. This surgery can take up to 3 hours or more and can result in a hospital stay of up to 5 days.

SI Joint Fusion Recovery

After your SI joint fusion, you'll be moved to the recovery area to regain consciousness. Any pain or discomfort can be managed using intravenous pain medication. You will then be discharged with oral medication for pain.

You'll usually stay in the hospital for a 24-hour period, and any pain or discomfort can be managed using intravenous pain medication. You will then be discharged with oral medication for pain the next day. This is rare, but more common with elderly patients.

Using the minimally invasive SI joint fusion procedure, patients enjoy the advantages of:

  • No bone harvesting: preserving both the bone and surrounding ligaments
  • Faster recovery time: most patients are up and walking within 24 hours
  • Less scarring due to smaller incisions
  • Less blood loss than traditional back surgery
  • Shorter hospital Stay: one day in most cases

Management of SI joint pathology will depend on the duration and severity of your back pain, and the dysfunction you're experiencing. Generally, one session of physical therapy is performed as needed to teach patients the dos and don'ts after surgery.

We ask that the patient does not put full pressure on the side of the surgery for 3-4 weeks and teach how to do "non-weight bearing toe touch ambulation with walker" before leaving the hospital. Because of this "non-weight bearing" status, we do not perform bilateral surgery except in special situations to keep you on your feet and ambulatory.

Typically, both SI Joints are involved in the disease, and our experience shows in half of the cases after fixing the most symptomatic side the patient is able to use the joint more, and fixing the other side is not necessary to avoid pain. In the other half of the patients, we return to fix the other side after the patient safely and securely can put full pressure on the first surgical side.

How Effective and Safe is SI Joint Fusion?

To date there have been over 20,000 SI fusions performed in the US. This procedure is also suitable for the elderly. This is important, because about 38% of patients with SI joint pain are over the age of 65 years old. This group is not likely to respond well to conservative treatment such as physical therapy due to the degenerative nature of the condition.

Inspired Spine always researches and recommends the simplest, least-invasive approach that is appropriate to your specific condition.

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