Minimally invasive SI joint fusion uses small titanium implants placed across the sacroiliac joint to stabilize it permanently. This is considered for patients with significant SI joint instability or those who have not achieved lasting relief from injections and radiofrequency ablation.
Triangular titanium implants (typically 3) are placed across the SI joint under fluoroscopic guidance through a small incision on the buttock. The implants' textured surface promotes bone in-growth over time, creating a solid fusion that stabilizes the joint.
Recovery is significantly faster than traditional open SI joint surgery. Most patients use a walker or crutches for 2-3 weeks. Success rates exceed 80% in properly selected patients.
The iFuse implant system uses triangular titanium rods that are placed across the SI joint to provide immediate mechanical stabilization. The triangular shape resists rotation within the joint, providing superior stability compared to round implants. Over time, bone grows into the textured implant surface, creating biological fixation.
The procedure is performed through a small incision (approximately 3-4 cm) in the buttock. Under fluoroscopic guidance, a guide pin is placed across the SI joint, and the implant is inserted over the guide pin. Typically, three implants are placed in a triangular configuration.
The procedure is performed in an operating room under general or spinal anesthesia. The surgery typically takes 45-60 minutes. Most patients go home the same day or stay overnight for observation.
Pain from SI joint instability is typically relieved immediately after surgery due to the stabilization provided by the implants. Some incisional pain is expected and managed with oral medications.
Patients use crutches or a walker for 2-3 weeks, then gradually transition to unassisted walking. A structured physical therapy program is essential for optimal recovery. Driving is typically permitted at 2-3 weeks after surgery.
Heavy lifting, bending, and twisting should be avoided for 6-8 weeks. Most patients return to sedentary work within 2-4 weeks and to full activity by 3-6 months.
SI joint fusion is indicated for patients with confirmed SI joint dysfunction who have failed at least 6 months of conservative treatment. Contraindications include active infection, severe osteoporosis, and medical comorbidities that increase surgical risk.
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