If you have been diagnosed with sacroiliac (SI) joint dysfunction and conservative treatments such as physical therapy, medications, or injections haven’t provided lasting relief, your doctor may recommend posterior sacroiliac joint fusion as a treatment option. This surgical procedure is designed to relieve pain caused by dysfunction, degeneration, or destruction of the ligaments of the sacroiliac joint, which connects the spine to the pelvis.
The sacroiliac joint is crucial in supporting the weight of the body and transferring force between the spine and lower limbs. When it becomes damaged or inflamed, it can lead to significant discomfort and mobility issues. Arguably, this is the most common cause of low back pain. Posterior sacroiliac joint fusion is a procedure where the joint is surgically fused to eliminate movement and relieve pain, helping restore function and improve quality of life.
At Endoscopic & Minimally Invasive Spine Specialists, we have extensive experience and expertise in sacroiliac joint fusion and provide the highest-quality care in surgical and non-surgical spine care.
To learn more about sacroiliac joint fusion surgery, call the office today or request an appointment online.
What is the Sacroiliac Joint?
The sacroiliac (SI) joint is located at the junction between the sacrum (the triangular bone at the base of the spine) and the ilium (the uppermost portion of the pelvis). There are two sacroiliac joints—one on each side of the body—and they play a key role in transferring the load from the upper body to the legs and stabilizing the spine during movement, walking, and other activities.
The sacroiliac joints are designed for limited motion. They are primarily responsible for absorbing shock and providing stability. However, when these joints become dysfunctional, degenerated, for destroyed, they can become a source of pain and discomfort, particularly in the lower back, buttocks, and hips, even radiating into the legs or groin.
Indications for Posterior Sacroiliac Joint Fusion
Posterior sacroiliac joint fusion is typically considered when conservative treatments have failed to provide enduring relief for patients suffering from conditions such as:
- Sacroiliac Joint Dysfunction (SIJD): This occurs when the SI joint becomes inflamed or misaligned, often due to injury, pregnancy, or degenerative changes. Pain is commonly felt in the lower back, buttocks, and legs.
- Sacroiliac Joint Degeneration: Over time, the cartilage in the SI joint can wear down, leading to osteoarthritis and joint instability. This can cause chronic pain and difficulty with movement.
- Traumatic Injury: Fractures, dislocations, or sprains of the sacroiliac joint caused by accidents or falls can lead to chronic pain and instability.
- Spondylitis or Ankylosing Spondylitis: These conditions involve inflammation in the spine and joints, including the sacroiliac joint. They can lead to pain, stiffness, and reduced mobility.
What is Posterior Sacroiliac Joint Fusion?
Posterior sacroiliac joint fusion is a surgical procedure designed to treat pain in the SI joint by eliminating movement at the joint and promoting bone growth across the joint to fuse the two bones together. The goal is to stabilize the joint and relieve pain by preventing the joint from moving. The pathologic movement of the joint causes inflammation and discomfort.
Unlike some other forms of spinal surgery, posterior SI joint fusion involves accessing the joint from the back (posterior) of the body rather than through the front or side. The fusion process involves using bone grafts, screws, or other surgical devices to stabilize the joint and facilitate bone healing. Over time, the sacrum and the ilium grow together, effectively fusing the joint.
Benefits of Posterior Sacroiliac Joint Fusion
Posterior sacroiliac joint fusion offers several benefits for patients who suffer from chronic pain due to SI joint dysfunction or degeneration:
- Pain Relief: The primary benefit of the procedure is the relief of chronic pain caused by SI joint dysfunction, especially pain that radiates to the lower back, buttocks, and legs. By fusing the SI joint, the movement that causes pain is eliminated.
- Improved Mobility: Many patients experience improved function and mobility after surgery as the fusion stabilizes the joint and prevents the painful motion that was limiting their activities.
- Increased Quality of Life: With reduced pain and improved mobility, patients typically report a better quality of life after recovery, with fewer limitations on daily activities and a decrease in reliance on pain medications.
- Long-Term Solution: Sacroiliac joint fusion can provide a long-lasting solution for chronic pain. Unlike other treatments that offer temporary relief, fusion aims to provide permanent pain reduction and stabilize the joint for the future.
The Procedure
Posterior sacroiliac joint fusion is typically performed under general anesthesia, meaning you will be asleep and pain-free throughout the surgery. Here is an overview of the surgical process:
- Incision: The surgeon makes a small incision in the lower back on the side of the pathology, to access the posterior (back) side of the sacroiliac joint.
- Exposure of the SI Joint: The muscles and tissues around the SI joint are carefully moved aside, and the joint is exposed.
- Preparation of the Joint: The cartilage on the surface of the sacrum and ilium is removed to prepare the bones for fusion. Bone graft material is placed between the two bones to promote healing and encourage fusion.
- Placement of Implants: The surgeon may insert screws, plates, clips, or other devices to stabilize the joint during the healing process. These implants help hold the joint in place while the bone graft heals and fuses the sacrum and ilium together.
- Closure: Once the fusion materials are in place, the surgeon closes the incision with sutures beneath the skin and surgical glue, and a dressing is applied to the surgical site.
Risks and Complications
As with any surgical procedure, posterior sacroiliac joint fusion carries some risks. While complications are rare, it is important to be aware of the potential issues:
- Infection: There is always a risk of infection with surgery, particularly at the incision site or in the deep tissues surrounding the joint.
- Nerve Injury: Although extremely rare and highly unlikely, there is a reported risk of nerve injury during the procedure, which could result in pain, numbness, weakness, or tingling in the lower back, buttocks, or legs.
- Implant Failure: The hardware used to stabilize the SI joint may loosen or break over time, potentially requiring revision surgery.
- Nonunion or Delayed Fusion: In some cases, the bones may not fuse properly or may take longer than expected to fuse. This can delay recovery and may require additional treatments or surgeries.
- Blood Clots: As with all surgeries, there is a risk of developing blood clots in the legs (deep vein thrombosis), which can travel to the lungs (pulmonary embolism) and cause serious complications.
Recovery After Posterior Sacroiliac Joint Fusion
Recovery from posterior sacroiliac joint fusion can take several months. The length of recovery varies depending on the individual and their overall health. Here is an overview of what to expect:
- Facility Stay: Most patients stay in the facility for 1-2 hours following surgery. During this time, you will be monitored for any complications, and pain management will be addressed.
- Pain Management: You will likely experience some pain and discomfort after surgery, especially in the lower back and around the surgical site. Pain management strategies will be provided, including medications and possibly ice therapy.
- Activity Restrictions: In the first few weeks after surgery, you will need to limit your physical activity to avoid putting stress on the healing joint. Walking and light activities may be allowed, but you should avoid heavy lifting, twisting, or bending for several weeks.
- Physical Therapy: After the initial healing period, physical therapy may be recommended to help restore strength and flexibility to your back and pelvis. A rehabilitation program will also focus on improving posture, gait, and movement patterns to ensure the best outcome.
- Healing and Fusion: Full fusion of the SI joint can take anywhere from 3 to 12 months, depending on the individual and the method of fusion used. During this time, you may be asked to wear a support garment to protect the joint.
- Follow-Up Appointments: You will have regular follow-up appointments with your surgeon to monitor your progress, check for complications, and assess the fusion process using imaging such as X-rays.
Long-Term Outlook
Most patients who undergo posterior sacroiliac joint fusion experience significant and remarkably quick relief from pain and improvement in function. However, it is important to note that the fusion is permanent, and once the joint is fused, it will no longer move. While this eliminates the pain caused by abnormal motion, it may slightly change the mechanics of the pelvis and lower spine.
Long-term success rates are generally extremely high, and nearly all patients report being able to return to normal activities, including work, exercise, and daily routines, after a full recovery. However, maintaining a healthy weight, practicing good posture, and engaging in good diet and regular exercise can help protect the spine and reduce the risk of future problems.
Contact EMISS To Schedule Your Procedure
Posterior sacroiliac joint fusion is an effective surgical option for patients suffering from chronic pain caused by SI joint dysfunction or degeneration. The procedure aims to stabilize the joint and provide lasting pain relief, improving mobility and quality of life. While the surgery carries some risks, the benefits—especially for those with severe, treatment-resistant SI joint pain—can be life-changing. As with any surgery, it’s essential to discuss your treatment options thoroughly with your healthcare provider to ensure you are making the best choice for your condition and long-term health.
To learn how you can benefit from posterior sacroiliac joint fusion and patient-centered care your spinal problems, call Endoscopic & Minimally Invasive Spine Specialists today, or book an appointment online.
