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Surgery for Sacroiliac Joint Dysfunction

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Surgery for sacroiliac (SI) joint dysfunction is rarely used, and it’s usually only considered if you’ve tried all other non-surgical treatments for SI joint pain, such as exercise, physical therapy, and medications, and you haven’t found pain relief.

SI joint stabilization—or SI joint fusion as it’s sometimes called—is a surgery that can help you cope with SI joint pain and other SI joint dysfunction symptoms.

Traditional open spine surgery to fuse the SI joints carries some risks (eg, infection and other complications). But doctors are increasingly performing minimally invasive SI joint fusion—a less invasive alternative to open spine surgery—which may mean fewer risks for you.

Some of the potential benefits of minimally invasive SI joint fusion:

  • less post-operative pain
  • reduced blood loss
  • smaller incision and less damage to surrounding tissues (eg, muscles)
  • speedier recovery than open spine surgery

With SI joint fusion, the goal is to stabilize the SI joints. Healthy SI joints provide stability for your pelvis (SI joints connect the spine to the pelvis), and they support the weight of your upper body. However, with SI joint dysfunction, the joints begin to wear and tear. Surgery helps to restore stability to these joints.

During SI joint surgery, your surgeon will stabilize the SI joints using fusion and instrumentation.

The instrumentation used during surgery—sometimes referred to as implants or spinal hardware—will help keep the joints in place as the bones fuse. Instrumentation is typically made of titanium or other metals.

The use of intra-operative computed tomography (CT) scans and image-guided surgery techniques during surgery have made SI joint fusion quicker and safer. However, long-term results are still pending.

After surgery, you’ll most likely need to be on crutches for about 3 weeks. The good news is that if your SI joint pain is on just one side, your recovery time will be quicker (than if you had pain on both sides). But if you’ve had a previous spine fusion, it may take longer for you to recover.

Is SI Joint Fusion an Option for You?
Remember, not everyone with SI joint pain needs surgery, but if you do have SI joint pain and have tried non-surgical treatments (and they haven’t reduced your pain), know that SI joint fusion may be able to help address your pain and other symptoms.

Also, it is important to remember that surgery should not be considered a first-line treatment for SI joint pain except in rare and serious cases (eg, infection, tumor).

The decision to have surgery for sacroiliac joint dysfunction is yours alone; be sure to arm yourself with information about SI joint fusion so that you can make the best decision for you.

Updated on: 12/15/11
Jonathan N. Sembrano, MD
This article was reviewed by Jonathan N. Sembrano, MD.
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