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SI Joint Fusion

The SI joint, or sacroiliac joint, is an important part of the body where your spine and pelvis connect. It’s located at the lower part of your back, right above your tailbone, and there are two of them – one on each side of your spine.

These joints are small, sturdy hinges that connect your pelvic bones (the large, curved bones that make up your hips) to your sacrum, which is the triangular bone at the base of your spine. They don’t move a lot, but they play a big role in supporting your body and helping you move.

The main roles of the SI joint are to provide stability and offset the load of the upper body to the lower limbs. The stability of the joint is provided by an extensive architecture of ligamentous structures.

Sacroiliac (SI) joint fusion is a surgical procedure aimed at stabilizing the sacroiliac joint, which is located at the junction between the spine and the pelvis. This joint can be a source of chronic lower back pain for some individuals. The main objective of SI joint fusion is to alleviate pain caused by sacroiliac joint dysfunction, which can be due to various factors such as injury, arthritis, or pregnancy.

Sacroiliac (SI) joint fusion is typically indicated in cases where there is significant and chronic pain originating from the sacroiliac joint that has not responded to conservative treatments; and that pain significantly affects the quality of life of a patient.

The decision to proceed with this surgical procedure is based on a combination of clinical evaluation, patient history, and diagnostic tests. SI joint fusion is generally considered a last-resort treatment after other therapies have been exhausted. 80% of patients endorsed clinically significant pain improvement following surgical fusion.

The procedure involves the fusion of the sacrum (the lower part of the spine) to the ilium (the upper part of the pelvic bone), effectively eliminating motion at the joint. This is done to reduce or eliminate the pain that arises from the joint’s abnormal movement or inflammation.

There are several techniques for performing SI joint fusion. The specific surgical approach is chosen based on the patient’s overall health, the nature of their SI joint dysfunction, and the surgeon’s expertise. These are the most common techniques.

  • Minimally Invasive Surgery (MIS): This approach uses small incisions and specialized instruments to place implants across the SI joint. These implants are designed to stabilize the joint and promote bone growth that will eventually fuse the joint. MIS is generally preferred due to its reduced recovery time and less postoperative pain compared to open surgery.
  • Open Surgery: In some cases, a more traditional open surgical approach may be necessary. This involves a larger incision and direct visualization of the joint for fusion. It is more invasive and may require a longer recovery period.
  • Percutaneous Fusion: This technique involves inserting rods, screws, or other stabilizing devices through the skin and into the joint. It is less invasive than open surgery but more so than MIS.

Recovery and rehabilitation after sacroiliac (SI) joint fusion surgery are crucial phases that play a significant role in the success of the procedure and the overall improvement in the patient’s quality of life.

Postoperative care includes a short hospital stay, pain management, wound care and activity restrictions to prevent stress on the fusion. This might include limiting bending, twisting, or lifting heavy objects.

Rehabilitation typically begins with gentle exercise to improve flexibility and range of motion and progresses to strengthening exercises. Longer term, the goal of SI joint fusion is to achieve a solid fusion of the bones, which can take several months. During this time, patients need to follow their surgeon’s guidance on activity levels. Patients may need to make long-term adjustments in their activities and lifestyle to protect the fused joint and prevent additional strain on other parts of the spine and pelvis.

Schedule a hip consultation

At Silicon Valley Orthopedics, we treat athletes and non-athletes alike with cutting edge techniques and procedures as well as nonsurgical options that will help healing when time and patience are in order. Contact us to schedule a consultation at one of our offices in Fremont, Los Gatos or Menlo Park. We strive to provide all of our patients with world-class compassionate and personalized orthopedic care aimed at your specific needs.