Sacroiliac joint fusion is a minimally invasive, image-guided procedure that stabilizes a painful, unstable sacroiliac (SI) joint — an option our specialists consider when injections and nerve ablation no longer provide lasting relief.
OVERVIEW
What sacroiliac joint fusion is and how it works
The sacroiliac (SI) joint connects the base of your spine (the sacrum) to your pelvis (the ilium). When this joint becomes unstable or degenerates, it can produce deep, persistent pain in the low back, buttock, and hip. Sacroiliac joint fusion is a procedure that bridges the sacrum and the ilium so the joint stops moving abnormally, with the goal of reducing the mechanical pain that comes from an unstable or worn joint.
At Columbia Pain & Spine Institute, fusion is performed using a minimally invasive, image-guided technique. Through a small incision, the physician places specialized implants across the joint to bridge the sacrum and ilium and encourage stabilization over time. Because the approach uses small instruments rather than a large open exposure, it is typically associated with a smaller incision and a more contained recovery than traditional open fusion surgery, though every case is different.
Fusion is generally considered only after less invasive options have been tried. Most patients first confirm the SI joint as the pain source with diagnostic SI joint injections, and many obtain relief from a sacroiliac joint nerve block or radiofrequency ablation first. When those measures no longer control the pain, fusion may be an appropriate next step for carefully selected patients.
CONDITIONS
Conditions sacroiliac joint fusion may help
Fusion is most often considered for chronic SI joint pain that has been confirmed with diagnostic injections and has not responded to more conservative care.
Commonly treats
YOUR VISIT
What to expect
Before
Your physician reviews your history, imaging, and prior injection or ablation results to confirm the SI joint is the source of your pain. You will receive instructions on medications, fasting, and arranging a ride home, since sedation or anesthesia is used.
During
The procedure is performed on an outpatient basis using live X-ray (fluoroscopic) guidance. Through a small incision, implants are placed across the joint to stabilize it. Image guidance lets your physician confirm precise implant placement throughout the procedure.
After
You rest in recovery and typically go home the same day. Your physician may recommend a period of limited weight-bearing, followed by a gradual return to activity over the following weeks, and will outline a personalized recovery and follow-up plan.
Recovery timelines differ from person to person depending on activity level, the number of implants used, and overall health, so it is important to follow the specific guidance your care team provides.
QUESTIONS
Frequently asked questions
How is fusion different from an SI joint injection or nerve block?
An injection or nerve block delivers medication to diagnose the joint or temporarily calm pain, but it does not change the joint’s mechanics. Fusion is a structural procedure that stabilizes an unstable joint, so it is considered when those less invasive treatments no longer provide adequate relief.
Is the procedure minimally invasive?
Yes. We use a minimally invasive, image-guided approach through a small incision rather than a large open surgery. This is generally associated with a smaller incision and a more contained recovery than open fusion, though every case is individualized.
Will I be put to sleep?
Fusion is performed with anesthesia or sedation for your comfort, so you will need someone to drive you home. Your team will review the specific anesthesia plan with you before your procedure date.
NEXT STEPS
Talk with our Gresham & Portland team
If SI joint pain in the greater Portland and Gresham area has not responded to injections or ablation, our dual board-certified, fellowship-trained physicians can review whether sacroiliac joint fusion is an option for you. Procedures are performed on an outpatient basis in association with our on-site Burnside Surgery Center. New patients are welcome by physician referral, and records may be faxed to (503) 382-8120.
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