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Sacroiliac Joint Fusion (SI Fusion)


What are the indications for a sacroiliac joint fusion?

The sacroiliac joint is located in the medial aspect of the upper buttock region and is a fairly common cause of back pain. SI fusion surgery is indicated for patients with sacroiliac joint pain that has failed conservative options including medications, physical therapy and injections. Other potential causes of low back pain such as pain coming from the spine or the hip joint must be ruled out.  

How is sacroiliac joint fusion performed?

Sacroiliac joint fusion is a minimally invasive procedure done under general anesthesia. A small incision about 1-2 inches long is made along the side of the buttocks. A fluoroscopy machine (X-ray) is used to visualize the spine and pelvic structures centering over the sacroiliac joint.  Flouroscopic guidance affords specialized instruments access to the pelvis, sacroiliac joint and sacrum. Typically three triangular titanium rods are placed across the sacroiliac joint providing immediate fixation and stabilization. The incision is closed with absorbable sutures. The surgery takes approximately one hour.  

What is the recovery for a sacroiliac joint fusion surgery?

The hospital stay usually varies from 2-4 days. There is usually pain localized to the lower back/buttock area after the surgery. The surgical pain usually significantly improves by 2-3 months. The original pain caused by the sacroiliac malfunction should be significantly better within 3 months of surgery. It is recommended to partially weight bear on the affected leg for the first 3 weeks by using either crutches or a walker. After 3 weeks, full weight bearing should be tolerated. Activity recommended after the first 3 weeks includes short walks and mainly rest.  Physical therapy guidance is recommended from 3 weeks after the surgery for 6-8 weeks. Return to work can vary depending on the rate of recovery and physical demands of the job. For a nonphysical job, reasonable timeline to return to work is 1-3 months whereas more labor intensive work may require to be out of work for up to 3-6 months.  

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