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Joint stabilization

Minimally Invasive SI Joint Fusion

Stabilization after disciplined diagnostic confirmation

Minimally invasive sacroiliac joint fusion stabilizes a confirmed painful SI joint after non-surgical care and diagnostic injections have not provided durable control.

This guide is educational and cannot determine candidacy. Every treatment has limitations and risks, and outcomes are not guaranteed. A clinician must review your diagnosis, health history, imaging, medicines, and goals.

What it targets

A procedure built for a particular pain mechanism.

The SI joint transfers load between the spine and pelvis. Degeneration, inflammation, or abnormal motion may produce pain near the posterior pelvis and buttock. Fusion places implants across or within the joint to reduce painful motion and promote bone growth; it will not treat coexisting lumbar or hip pain generators.

Who may be evaluated

Candidacy begins with diagnostic fit.

Because SI-joint symptoms overlap with lumbar-spine and hip disorders, a multi-step diagnostic process is essential before a permanent stabilization procedure is considered.

Clinical considerations

  • Chronic SI-region pain and meaningful functional limitation, often for six months or longer
  • Multiple positive SI-joint provocative tests on examination
  • Short-term, substantial relief after an image-guided intra-articular diagnostic block
  • Incomplete response to physical therapy, medication, activity modification, and indicated injections
  • Imaging and examination that exclude a stronger hip, lumbar, infection, fracture, or tumor explanation

Evaluation may include

  • History and examination using a cluster of SI-joint stress maneuvers
  • Pelvic, hip, and lumbar imaging when needed to evaluate competing diagnoses
  • Fluoroscopy-guided intra-articular local-anesthetic block
  • Review of prior non-surgical treatment and procedure-specific coverage criteria

How it is performed

The procedure, step by step.

1

Approach selection

The physician chooses a lateral transarticular or posterior approach according to anatomy, evidence, and the planned implant system.

2

Image-guided implant placement

Through a small incision, one or more implants are positioned to stabilize the joint and create a scaffold for fusion.

3

Rehabilitation and fusion monitoring

Activity and weight-bearing progress in stages while symptoms, function, implant position, and healing are followed.

After the procedure

Recovery, follow-up, and important risks.

Recovery & follow-up

  • Some patients require temporary partial weight-bearing or an assistive device.
  • Incision care and movement restrictions depend on the approach and implant system.
  • Rehabilitation focuses on safe mobility, hip and trunk strength, and gradual return to activity.
  • Bone fusion develops over time, so early symptom change does not by itself confirm long-term fusion.

Risks & limitations

  • Infection, bleeding, nerve injury, and anesthesia-related complications
  • Implant malposition, migration, fracture, or irritation
  • Delayed union, nonunion, or need for revision surgery
  • Persistent pain from the SI joint or another untreated pain source

Alternatives to discuss

SI-focused physical therapy and activity modification
Medication and image-guided SI-joint injection
Radiofrequency treatment of selected sacral nerve branches
Open fusion in uncommon situations where it is clinically indicated

Evidence & technology

What is established—and what is still being studied.

Evidence in context

Randomized and prospective studies support minimally invasive fusion for selected patients, but much of the evidence is device-specific. Comparative data across posterior and lateral systems are less mature, making diagnostic rigor and transparent technology selection important.

Brands are examples, not endorsements

iFuse, Rialto, and other FDA-cleared systems illustrate different implant and approach options. Listing a system does not imply that it is the only technology used or the right choice for every patient.

Common questions

A useful conversation starts here.

Bring the questions with you

Find out whether the diagnosis fits the treatment.

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