Surgery for Sacroiliac Joint Dysfunction

Surgery to fuse one or both sacroiliac joints may be an option if non-operative treatments are ineffective at managing pain and other symptoms related to SI joint dysfunction.

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Surgery for sacroiliac (SI) joint dysfunction is only considered if you’ve tried non-surgical treatments for SI joint pain, such as physical therapy, medications, and injections and you haven’t found pain relief.
medical colleagues looking at x-ray imageWhile surgery is a last resort treatment, sacroiliac joint fusion surgery, now a minimally invasive type of surgical procedure, may be an option if non-operative treatments are ineffective. Photo Source: joint stabilization—or SI joint fusion as it’s sometimes called—is a surgery that can help reduce or alleviate your SI joint pain and other symptoms related to SI joint dysfunction.

Traditional open spine surgery to fuse the SI joints carries some risks, such as infection. 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

The goal of SI joint fusion is to stabilize one or both sacroiliac joints. When both SI joints require surgery, one joint is treated and a second surgery is scheduled after full recovery from the first procedure. The sacroiliac joints help stabilize your pelvis (SI joints connect the spine to the pelvis) and support the weight of your upper body. However, with SI joint dysfunction, the joints begin to wear. 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 joint fuses. Instrumentation is typically made of titanium or other metals.

The use of intraoperative computed tomography (CT) scans supports image-guided surgical techniques making SI joint fusion quicker and safer.

After surgery, you’ll 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: 02/05/19
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Jonathan N. Sembrano, MD
Assistant Professor in Orthopaedic Surgery
University of Minnesota Medical School
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