Minimally Invasive SI Fusion
Minimally Invasive Treatment for Chronic Sacroiliac Joint Pain
Chronic sacroiliac (SI) joint pain can make everyday activities such as walking, sitting, standing, climbing stairs, or sleeping difficult. When pain continues despite conservative treatments and less-invasive procedures, SI joint fusion may be an option for carefully selected patients.
SI joint fusion is a minimally invasive procedure designed to stabilize the painful sacroiliac joint and reduce abnormal movement that may be contributing to chronic pain.
At Kansas Pain Management, our physicians evaluate each patient’s symptoms, physical examination findings, medical history, and response to diagnostic treatments to determine whether SI joint fusion may be appropriate.
What Is the Sacroiliac (SI) Joint?
The sacroiliac joints are located where the lower spine (sacrum) connects with the pelvis (ilium). There are two SI joints—one on each side of the pelvis.
These joints help transfer forces between the upper body and legs and provide stability between the spine and pelvis. Although the SI joints normally move only a small amount, inflammation, degeneration, injury, or instability can cause pain.
SI joint pain is commonly felt in the lower back or buttock and may sometimes extend into the hip, groin, or upper leg.
Because symptoms can overlap with conditions involving the lumbar spine or hip, an appropriate evaluation is important before treatment.
What Is SI Joint Fusion?
SI joint fusion is a procedure that stabilizes the sacroiliac joint by placing specialized implants across the joint to limit painful movement and promote fusion.
Unlike an SI joint injection, which delivers medication into the joint to provide diagnostic information and/or temporary pain relief, SI joint fusion is intended to provide longer-term stabilization of the affected joint.
When performed using a minimally invasive approach, the procedure generally uses image guidance to accurately position the implants while minimizing disruption to surrounding tissues.
When Is SI Joint Fusion Recommended?
SI joint fusion is not appropriate for every person with SI joint pain.
It may be considered when:
- SI joint pain has persisted despite appropriate conservative treatment.
- The SI joint is strongly suspected to be the primary source of pain.
- Physical examination findings support SI joint involvement.
- Diagnostic SI joint injection supports the SI joint as a significant pain generator.
- Pain significantly interferes with daily activities or quality of life.
- Other potential causes of lower back, hip, or pelvic pain have been evaluated.
- Less-invasive treatments have not provided adequate or lasting relief.
Current clinical guidance emphasizes careful patient selection and confirmation of the SI joint as the pain source before considering fusion.
Who May Be a Candidate for SI Joint Fusion?
A patient may be considered for SI joint fusion when chronic SI joint pain continues despite non-surgical treatment.
Your physician may evaluate:
Your symptoms and medical history
Your physician will ask about the location, duration, severity, and pattern of your pain, as well as previous injuries, treatments, surgeries, and other medical conditions.
Physical examination
Specific physical examination maneuvers may be used to reproduce your typical pain and assess whether the SI joint may be contributing to your symptoms.
Diagnostic SI joint injection
A fluoroscopy-guided SI joint injection may be used as part of the diagnostic process. A meaningful temporary reduction in the patient’s typical pain after a diagnostic injection can support the SI joint as the pain generator.
A positive injection does not necessarily mean that fusion is required. Your physician considers the injection response together with your symptoms, examination, treatment history, and other diagnostic information.
Response to conservative treatment
Before considering fusion, physicians generally look for an adequate trial of non-surgical treatments when medically appropriate, such as physical therapy, activity modification, medications, and other interventional treatments.
How Does Minimally Invasive SI Joint Fusion Work?
The exact technique depends on the patient’s anatomy, diagnosis, and the approach selected by the treating physician.
In general, minimally invasive SI joint fusion involves:
- Patient evaluation and preparation
Your physician reviews your medical history, examination findings, imaging, and previous treatments. - Image-guided positioning
The procedure is performed using imaging guidance to help the physician accurately identify the appropriate location. - Small surgical access point
A small incision is used to access the SI joint. - Preparation of the joint
The physician prepares the appropriate area to facilitate stabilization and fusion. - Implant placement
Specialized implants are positioned across the SI joint to stabilize the joint and promote fusion. - Closure and recovery
The incision is closed, and you are monitored during your recovery before being discharged according to your physician’s instructions.
The specific surgical approach and implant system may vary based on the patient’s condition and the physician’s clinical judgment.
What Are the Benefits of SI Joint Fusion?
For appropriately selected patients, minimally invasive SI joint fusion may:
- Stabilize a painful SI joint
- Reduce painful abnormal movement
- Address chronic SI joint pain when conservative treatment has not provided sufficient relief
- Reduce pain that interferes with daily activities
- Support improved physical function
- Provide a longer-term treatment option for appropriately diagnosed SI joint pain
The goal of treatment is not simply to treat an imaging finding but to address symptoms and functional limitations associated with the affected SI joint.
What Can I Expect After SI Joint Fusion?
Recovery varies depending on the surgical approach, the patient’s overall health, and individual circumstances.
Your physician will provide specific instructions regarding:
- Activity restrictions
- Weight-bearing
- Wound care
- Medications
- Physical therapy or rehabilitation
- Follow-up appointments
- Gradual return to normal activities
Some patients may experience soreness around the treatment area during the early recovery period. Improvement in pain and function can occur progressively as healing takes place.
Follow your physician’s post-procedure instructions carefully and contact the medical team if you experience concerning symptoms.
Risks and Potential Complications
As with any medical procedure, SI joint fusion has potential risks and complications.
Depending on the procedure and individual circumstances, these may include:
- Infection
- Bleeding
- Nerve or tissue injury
- Pain at or around the treatment site
- Implant-related complications
- Fracture or other bone-related complications
- Incomplete or unsuccessful fusion
- Persistent or recurrent pain
- Need for additional treatment or revision surgery
Your physician will discuss the potential benefits and risks with you before treatment so you can make an informed decision.
FAQs
Why Choose Kansas Pain Management?
At Kansas Pain Management, we take an individualized approach to diagnosing and treating chronic pain.
Our physicians evaluate the potential source of your pain before recommending an intervention. When appropriate, treatment may progress from conservative therapies to minimally invasive procedures based on your individual needs.
If you have persistent SI joint pain that has not improved with conservative treatment or less-invasive procedures, our team can evaluate whether SI joint fusion or another treatment option may be appropriate for you.
We serve patients throughout the Kansas City area and surrounding communities, including Overland Park, Lawrence, Leavenworth/Lansing, Roeland Park, Ottawa, Topeka, Belton, Manhattan, Lee’s Summit, Johnson County, and surrounding Kansas and Missouri communities.
The information on this page is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Treatment recommendations vary based on each patient’s individual condition.
Book an appointment here to learn more or call us at 913-339-9437 to schedule now.
Some Of The Other Surgical Procedures We Provide:
FAQs
SI joint injections are procedures used to diagnose or treat pain in the sacroiliac joint located at the upper buttock region.
Females, especially those who have given birth, are more prone due to pelvic joint changes from childbirth.
Yes, chronic pain from the SI joint can cause one leg to become weaker than the other.
If the pain worsens while sitting or starts interfering with daily activities, evaluation is recommended.
It is a procedure used to confirm suspected sacroiliac joint dysfunction by numbing the SI joint.
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