Why is SI Joint Fusion Performed?

Individuals experiencing SI joint pain can help relieve symptoms using physical therapy, nonsteroidal anti-inflammatory medications, joint injections, or adjustments in their daily routines. Unfortunately, some patients continue to experience debilitating pain even after routine nonsurgical therapy. For these candidates, an SI joint fusion may help offset their sacroiliac joint pain.

For patients that do not respond to nonsurgical treatments, SI joint fusion may be the best course of action to alleviate:

• Restricted mobility in the lower back, hips, groin, or legs

• Pelvic instability and chronic lower back pain resulting in difficulty walking up inclines, climbing stairs, standing, walking, or moving

• Sleep disruption caused by pain in the sacroiliac joint and discomfort from sitting or standing for extended periods

• Pain in the lower back, pelvis, hip, or groin that limits mobility and hinders daily life

How to Prepare for a SI Joint Fusion Procedure

Before committing to SI joint fusion, schedule an examination with a Resurgens physician. Your doctor will use diagnostic screening tools to examine the sacroiliac joint and determine if there are signs of degeneration. The doctor will be able to determine if the lower back and pelvic symptoms below the L5 vertebra are caused by the SI joint.

Your physician may also administer Lidocaine or a similar anesthetic agent into the sacroiliac joint. If you experience significant sacroiliac pain relief several hours after the injection, your doctor can confirm the pain source.

Once a candidate moves forward with surgery, they should refrain from taking anti-inflammatory NSAID medications seven days before the operation. These medications may prolong bleeding during the procedure. Patients should also not eat or drink anything after midnight the day before surgery. Smokers should stop smoking at least two weeks before surgery to lower the risk of postoperative bleeding. Patients should make sure to check in early and bring extra copies of their MRI or X-rays.

What Happens During a SI Joint Fusion Procedure?

First, you are given medicine to put you to sleep or block sensation in your SI joint. You're positioned face down. The surgeon makes a small opening in your skin. With the help of a video x-ray device called a "fluoroscope," a guide pin is placed into your SI joint. Fluoroscopy helps surgeons view real-time, moving images inside the patient during the procedure.

While protecting your soft tissues, the surgeon carefully drills a channel along this pin. It passes into the ilium, through the SI joint, and into the sacrum. The first implant is inserted, locking these bones together. Typically, two or more implants will be needed to stabilize your joint. Over time, new bone will grow on and around the implants and across the joint, creating a solid fusion. The entire SI joint surgery takes about an hour. The implant systems used during surgery also have fewer complications and faster recovery times than regular open-fusion surgeries.

Your physician will monitor you following the procedure. You may be allowed to go home, or you may stay overnight, depending on your needs. Your doctor will give you instructions to help your recovery.

Are There Risks Associated with SI Joint Fusion

All surgical procedures pose risks, and possible complications or issues from SI joint fusion include:

• Muscle or nerve damage near the SI joint

• Implant failure, migration, or breakage

• Infections near the site of the wound or re-opening of the wound

• Blood clots or hemorrhaging

• Bruising or swelling near the area of operation

• Adverse reactions to anesthesia

• Fracture of the bones surrounding the pelvis implants

• Allergic reaction or rejection of implants

• Increased pain in the pelvis or sacroiliac joint

• The need for additional surgery due to faulty implants

This is not an exhaustive list. Consult with your physician with any questions or concerns prior to surgery.

Post SI Joint Fusion & Recovery

The recovery time for a SI joint fusion typically takes up to six months for complete recovery. 82% of patients experience positive short-term and long-term relief of symptoms following surgery. However, the duration of rehabilitation and recovery is determined mainly by the severity of systems before surgery.

Patients can expect some mild pain or symptoms for several weeks following the procedure. Your physician will tailor your rehabilitation based on your individual needs. Your doctor may recommend a walker or cane for the first few weeks following surgery to reduce stress on the fused joints. Some candidates may also wear a sacral belt or pelvic brace to limit movement in the pelvis and stabilize the fused joint.

Patients can take pain medication to aid recovery, including over-the-counter medication or prescription painkillers in rare cases. During the early stages of recovery, patients should apply ice to their lower back or the surgical site to reduce inflammation. Also, a heating pad may help reduce muscle tension or spasms post-surgery.

Learn more about the Joint Replacement Center at Resurgens Orthopaedics.