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SI Joint Fusion

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The sacroiliac joint (SI joint) is located in the pelvis and links the pelvis to the lowest part of the spine above the tailbone. It is critical in protecting everyday trauma to the spine. Many problems can cause joint pain to this this lower part of the pelvis, and various types of SI joint treatment are available.

Do You Have SI Joint Problems?

The SI joint is a significant cause of low back pain. Clinical publications have identified the SI joint as a pain generator in 15-30% of chronic low back pain patients. In addition, the SI joint is a pain generator in up to 43% of patients with continued or new onset low back pain after a lumbar fusion.

Like any other joint in the body, the SI joint can be injured due to trauma or the aging of everyday wear and tear. When this happens, people can feel pain in their lower back and legs. Lifting, running, walking or even sleeping on the affected side becomes painful.

A sudden and traumatic injury, an existing condition (differences in leg length, twisted pelvis, or muscle imbalance), or inflammatory joint disease can cause sacroiliac pain. Hormonal changes during pregnancy can as well.

Symptoms of Lower Back Pain

  • Lower back pain
  • Sensation of lower extremity: pain, numbness, tingling, weakness
  • Pelvis / buttock pain
  • Hip/groin pain
  • Pain radiating down one or both legs
  • Feeling of leg instability
  • Disturbed sleep patterns due to pain
  • Unable to sit for long periods, sitting on one side
  • Pain going from sitting to standing

Making a Diagnosis

A variety of tests performed during physical examination will pinpoint the cause of SI joint as the cause of your symptoms, including:

  • X-rays
  • CT-scan
  • MRI

Is the SI Joint the Cause of Back Pain?

To determine whether the SI joint is the cause of your low back pain symptoms, a doctor may inject the SI joint with a local anesthetic. The injection will be delivered under either X-ray or CT to ensure the needle gets to the SI joint. If your symptoms are decreased by at least 50%, it can be concluded that the SI joint is either the source of or a major contributor to your low back pain. If the level of pain does not change after SI joint injection, it is less likely that the SI joint is the cause of your low back pain.

Treatment Options

Once the SI joint is confirmed as the cause of your symptoms, treatment can begin.

  • Physical therapy
  • Oral medications
  • Injection therapy

These treatments must be repetitive and frequent to relieve symptoms, and it must be noted that these therapies are temporary.

SI Fusion Surgery & Recovery

Sacroiliac joint fusion is a surgical procedure. Your surgeon will use a specially designed system to guide the instruments that prepare the bone and facilitate placement of the titanium implants across the sacroiliac joint.

Time must be allotted to allow the bones to fuse during healing after surgery, however continued pain and other symptoms can be expected, though will typically begin to alleviate within a few weeks. The entire recovery process for sacroiliac joint fusion can take up to six months.

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