Pain Management Procedures
Minimally Invasive Sacroiliac Joint Fusion
Minimally Invasive Sacroiliac Joint Fusion
What is SI joint fusion?
SI joint fusion is a procedure that stabilizes a painful sacroiliac joint by placing implants or other fusion material across or within the joint. The goal is for the sacrum and ilium to heal together and reduce painful joint motion. It is more invasive than an injection or RFA and is intended for carefully selected patients.
Who may be considered?
Candidates generally have significant, function-limiting SI-joint pain for months, have not improved enough after a structured nonsurgical program, and have examination findings and image-guided diagnostic injections that support the SI joint as the pain source. Imaging is used to exclude hip disease, nerve compression, fracture, infection, tumor, or another condition that would require different treatment. Coverage criteria vary and can be detailed.
What happens?
The procedure is performed with anesthesia in an appropriate surgical setting. Through one or more small incisions, the clinician uses fluoroscopy or three-dimensional navigation to place implants that bridge or stabilize the joint. Technique and implant design vary. Most minimally invasive procedures take around an hour, but the care team will give a specific estimate.
Recovery
Many patients go home the same day. A walker or cane may be needed, and weight-bearing, lifting, bending, and sitting can be restricted while fusion begins. Physical therapy and a gradual return to activity are individualized. Full recovery commonly takes months rather than days.
Important risks and limitations
Risks include infection, bleeding, blood clots, nerve injury, implant malposition or failure, failure of the bones to fuse, persistent pain, and need for revision. Fusion permanently changes joint motion and may not relieve pain from other sources. APG should confirm whether the procedure itself is performed by the practice or arranged at an affiliated facility before publication.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.