Persistent SI joint pain
Symptoms are chronic, functionally limiting, and clinically consistent with the SI joint as a meaningful pain generator.
MINIMALLY INVASIVE SI JOINT FUSION
A focused treatment for selected sacroiliac joint pain.
Minimally invasive sacroiliac (SI) joint fusion is designed for carefully selected patients with chronic SI joint pain when the diagnosis is well supported and appropriate non-surgical treatment has not provided adequate improvement.
THE SACROILIAC JOINT
Low back pain does not always come from the lumbar spine.
The SI joints connect the sacrum at the base of the spine to the pelvis. When an SI joint becomes a persistent pain generator, symptoms may be felt in the low back, buttock, or nearby regions.
Because SI joint symptoms can overlap with lumbar spine, hip, and other musculoskeletal conditions, diagnosis requires more than identifying where it hurts. History, examination, provocative maneuvers, imaging when appropriate, and response to diagnostic injection may all contribute to determining whether the SI joint is the likely pain generator.
PATIENT SELECTION
Who may be a candidate?
SI joint fusion is not a first-line treatment for most low back or buttock pain. Careful diagnosis and appropriate patient selection are essential before considering fusion.
Supportive examination
The history and physical examination, including a combination of SI joint provocative maneuvers, support the diagnosis.
Diagnostic confirmation
Image-guided diagnostic injection may help confirm that the SI joint is contributing meaningfully to the patient’s symptoms.
Persistent functional limitation
Appropriate non-surgical care has not provided adequate improvement, and symptoms continue to interfere with meaningful activity or quality of life.
THE PROCEDURE
How minimally invasive SI joint fusion works.
Using image guidance and a small surgical approach, implants are positioned across the SI joint to stabilize the joint and support fusion. The exact implant system, trajectory, and technique depend on the patient’s anatomy and the device being used.
The goal is not simply to treat pain in the general SI region. The procedure is intended for a well-supported SI joint diagnosis after other reasonable causes of symptoms have been considered.
EVIDENCE & EXPECTATIONS
Evidence supports careful selection—not automatic treatment.
Randomized trials comparing certain minimally invasive SI joint fusion systems with non-surgical management have reported improvements in pain, disability, and quality of life in selected patients, with benefits maintained in longer-term follow-up. However, the evidence is not uniform: a sham-controlled randomized trial did not demonstrate superiority over sham surgery at six months. These findings reinforce the importance of diagnosis, patient selection, informed expectations, and individualized decision-making.
Diagnosis firstSI-region pain alone is not enough to establish the SI joint as the pain generator.
Selection mattersFusion is considered after a focused evaluation and failure of appropriate non-surgical treatment.
Function mattersSuccess is assessed through meaningful improvement in pain, function, activity, and quality of life.
WHAT TO EXPECT
A diagnosis-driven treatment pathway.
Before treatment
Evaluation focuses on confirming the likely pain generator, reviewing prior care, examining relevant imaging, and determining whether diagnostic injection or additional evaluation is appropriate.
Procedure day
The SI joint is accessed through a minimally invasive approach, and implants are placed across the joint using image guidance. Procedure details vary by technique and implant system.
After treatment
Recovery and activity progression are individualized. Follow-up focuses on healing, function, symptom response, and a gradual return toward appropriate activity.
FREQUENTLY ASKED QUESTIONS
Common questions about SI joint fusion.
How do you know whether pain is coming from the SI joint?
Diagnosis is based on the overall clinical picture rather than any single finding. History, pain location, physical examination with provocative maneuvers, imaging when appropriate, and response to an image-guided diagnostic injection may all contribute to determining whether the SI joint is a meaningful pain generator.
Does SI joint pain mean I need fusion?
No. Most patients with suspected SI joint pain are initially treated non-surgically. Fusion is considered only for carefully selected patients with a well-supported diagnosis and persistent, functionally limiting symptoms despite appropriate non-surgical treatment.
Is SI joint fusion the same as an SI joint injection?
No. An SI joint injection may be used diagnostically and, in some situations, therapeutically. SI joint fusion is a different treatment approach that uses implants to stabilize the joint and support bony fusion.
Is SI joint fusion the same as radiofrequency ablation?
No. Radiofrequency procedures target nerve signaling and do not fuse the SI joint. SI joint fusion uses implants to stabilize the joint and support fusion. They are fundamentally different treatment approaches.
How quickly can I return to normal activity?
Recovery varies based on the procedure, implant system, individual health factors, and clinical progress. Activity restrictions and rehabilitation recommendations are individualized, and return to normal activity typically occurs gradually as recovery progresses.
NEXT STEP
Could the SI joint be the source of your pain?
A focused evaluation can help determine whether the SI joint is a meaningful source of your symptoms and whether minimally invasive SI joint fusion may be an appropriate treatment option.
Request an AppointmentThis page provides general educational information and does not replace an individualized medical evaluation. SI joint fusion systems have device-specific indications, contraindications, risks, and instructions for use. Treatment recommendations, alternatives, and expectations should be reviewed as part of an individualized treatment discussion.