SI Joint Fusion

In a fusion surgery, a bone graft and/or instruments are used to encourage bone growth over the sacroiliac joint and create one immobile unit. Joint fusion can effectively reduce pain and instability caused by sacroiliac joint dysfunction or inflammation (sacroiliitis). Most cases of sacroiliac joint pain can be treated using pain medication, injection treatments, chiropractic manipulation, and/or physical therapy, and surgery is usually not necessary.

Sacroiliac Joint Anatomy and Function

The sacroiliac joint is a low-motion joint that connects the hip bones to either side of the sacrum, acting primarily as a shock-absorber between the lower body and torso. This joint can also be thought of as the point where the base of the spine connects to the pelvis. The sacroiliac joint is a combination of a synovial joint and the sacroiliac ligaments. Dysfunction in the sacroiliac joint (also called the SI joint) can produce significant lower back pain, as well as the pelvic, groin, and hip pain. Sacroiliac joint dysfunction can be the result of too much motion, too little motion, or inflammation of the joint.

When Is Sacroiliac Joint Fusion an Option?

When the following symptoms persist for several weeks or months and do not respond to nonsurgical treatment, sacroiliac joint fusion may be recommended:

Significant lower back, hip, or groin pain that makes it difficult to function in everyday life and has not been effectively treated using nonsurgical methods. Sacroiliac joint pain can be felt on one or both sides of the body; one-sided low back pain is an early indication that the SI joint may be the pain generator. Pain is typically confined to the lower back and pelvis but may radiate down the back of the leg (sciatica).
Instability in the pelvis and lower back, which may cause pain or difficulty when standing, walking, or moving from sitting to standing or vice versa. Pain may be especially bad when climbing stairs or walking up an incline.
Stiffness and limited mobility in the low back, hips, groin, or legs.
Exacerbated pain after sitting or standing for long periods of time, or from certain sleeping positions, such as lying on the affected side for too long.

Most doctors or back pain specialists will recommend significant trials of nonsurgical methods (at least 8 to 12 weeks, but usually longer) before advising surgery.

Surgery

Implant systems for SI joint fusion have been developed in recent years that allow the procedure to be minimally invasive. The most commonly used systems have been shown to relieve excessive motion at the joint through fusion, minimizing pelvic and lower back pain. Additionally, these systems have been shown to cause fewer complications and require a less-extensive recovery process than open fusion surgeries.1,2

A typical SI Joint fusion procedure typically consists of the following basic steps:

The patient lays prone (face down) on the operating table under general anesthesia.
A small incision, usually ranging from 2 to 3 centimeters, is made in the side of the buttock and the gluteal muscles are dissected to access the ilium.
A small guide pin is inserted through the side of the ilium to create a small hole allowing access to the ilium. This opening is then broached or drilled through the ilium to provide passage for the implants to reach the sacrum.
If a bone graft is necessary, the SI joint is cleared of cartilage and soft tissues, and a bone graft is packed into the joint space. The bone graft is typically collected from a different area of the ilium or from shavings left behind from broaching the ilium.
The implant instruments are guided through the passage in the ilium and are put into place using screws, pins, or a mallet.
The incision site is then irrigated using a saline solution, which removes any debris from the wound before it is closed. Then, the incision is closed in layers using standard sutures.

Cost

The cost of SI joint fusion is based on several considerations. This can include both the extent of the procedure and a patient’s insurance carrier. Medicare can cover this procedure if it is deemed necessary treatment. BEST accepts Medicare, most private health insurances, and works with workers’ compensation claims and personal injury cases at all of our centers.

Reach out to BEST Health System Today

To learn more about SI joint fusion and if it is right for you, contact BEST Health System today. Our caring and experienced team of treatment professionals can help you develop a personalized treatment plan that is right for you. We are dedicated to getting you the quality of life you deserve.