Sacroiliac Joint Fusion: Minimally Invasive Surgery for Patients in New Jersey

The two sacroiliac joints in the body connect either side of the sacrum to the iliac bones of the pelvis. Sacroiliac joint pain and inflammation, known as sacroiliitis, can be caused by:

• Injury: A traumatic injury to the pelvis, such as a car crash, repetitive sports injury such as running, or a fall that causes extreme forces to be exerted on the SI joint(s) can result in sacroiliitis.
• Osteoarthritis: Arthritis is an inflammatory condition that causes joints begin to wear down and ligaments begin to lose their elasticity. The affected joints become stiff and painful. Osteoarthritis is common in most adults starting at 20 to 30 years of age.
• Pregnancy: During pregnancy, a patient’s body releases hormones that relax the pelvic ligaments and muscles, making it easier for the baby to have unrestricted growth and to pass through the birth canal. However, this natural accommodation can lead to stress on the sacroiliac joint. It may occur during the pregnancy or any time shortly thereafter.
• Ankylosing spondylitis: This is a specific form of arthritis that begins in the sacroiliac joints and spreads to the vertebrae. It causes long-term inflammation of the spine that can lead to new bone formations, making the spinal vertebrae into a bamboo-like shape.
• Pyogenic sacroiliitis: A rare cause of sacroiliitis, this condition is caused by a bacterial infection.

Patients with sacroiliitis may experience pain in their lower back, buttocks, or radiating down one or both legs but not below the knee. If the radiation goes below the knee, the origin of the pain is not limited to the sacroiliac joint.  At CNSO, our doctors are experts at isolating the origin of the pain which is critical to determining the correct treatment to administer. An SI joint pain may be aggravated by common daily movements, such as:

• Running
• Going up or downstairs
• Taking large strides
• Standing for long periods of time

Diagnosing Sacroiliac Joint Pain

Sacroiliitis can be difficult to diagnose because there are many different diagnoses that present similar symptoms all of which include lower back pain. Sometimes, the patient may have multiple areas of the lower back that are the pain generators.  It is critical to have a clear understanding of the combination of symptoms in order to decipher the correct diagnosis.  To accurately diagnose a patient who has back pain or buttock pain, the medical team at CNSO will conduct a thorough physical exam and review the patient’s complete medical history. To rule out other conditions and confirm the diagnosis of sacroiliitis, a doctor may also use:

• Imaging: An X-ray or magnetic resonance imaging (MRI) scan can help determine if there is damage to either sacroiliac joint.
• Physical Examination: The CNSO evaluating physician will place a patient’s lower back and legs into different positions to see if by increasing pressure on the SI joint, they are able to isolate the pain that is troubling the patient.
• Physical Therapy: If sacroiliitis is diagnosed, the physical therapist will provide an education of stretches and physical strengthening maneuvers so the patient can return and maintain their daily lifestyle.
• Injection treatment: A patient with sacroiliac joint pain may receive a steroid injection to provide temporary or perhaps permanent relief. If no relief is appreciated, then the injection effectively ruled out sacroiliitis as the cause of their lower back pain. These injections can be done by a pain management doctor both in the office under ultrasound guidance as well as at a surgical center under fluoroscopic guidance both without the need for an anesthesiologist.

Sacroiliac joint fusion surgery would never be offered unless the patient experienced temporary relief from an injection into the SI joint. After the patient appreciated the temporary relief, there can always be a return to the below conservative methods of treatment until the patient is prepared to have the sacroiliac joint fusion:

• Structured physical therapy
• Anti-inflammatory drugs
• Steroid injections
• Muscle relaxation techniques
• Heating pads

For some patients, conservative care options will be sufficient to manage sacroiliac joint pain. If a patient is still experiencing significant joint pain, the CNSO doctor will recommend the minimally invasive sacroiliac joint fusion. After the one-hour procedure which can be performed in a surgical center or in a hospital, the patient can return to any athletic lifestyle and daily living activities.

Procedure and Recovery

For patients who qualify for a sacroiliac joint fusion a surgery would be scheduled in New Jersey. The surgery is considered a same day outpatient procedure. On the day of surgery, patients arrive one hour before the scheduled case during which time, the nurses will prepare the patient. The surgery itself will take only one hour. Recovery immediately after the surgery will last for an additional hour before the patient will be discharged to home.  

 After the patient is asleep under general anesthesia, the CNSO neurosurgeon or orthopedic spine surgeon will first make a small, one centimeter incision over the SI joint. Then under direct visualization, the surgeon will prepare the SI joint and insert a small metal device to join the sacrum and the iliac bone thereby fusing the two bones together. This stabilizes the joint and will eliminate the symptoms of pain and discomfort.

Because sacroiliac joint fusion is a minimally invasive procedure, patients are usually able to get back on their feet, walk, and perform daily tasks immediately after the surgery. Patients may experience some mild discomfort after fusion surgery, which is treated with pain medication. Some patients take a few weeks off from work or school to recover. After three weeks, CNSO strongly recommends physical therapy to help speed up recovery. An SI joint fusion patient can return back to any level of athletic activity within three months.

Expert and Convenient Care

The surgeons, physiatrists, physical therapists, and nursing support staff at CNSO are committed to providing best-in-class care for patients in NJ, regardless of where the patient lives. The CNSO team takes the time to listen to each patient so the correct diagnosis and treatment is provided. The CNSO neurosurgeons, orthopedic spine surgeons, and pain management doctors have been recognized as a Top Docs by their medical peers since 2013.  Together, they all work to diligently and expediently ensure the best treatment outcomes for each patient.

Learn More from CNSO about Joint Pain Treatment Options

Patients with lower back pain and joint pain shouldn’t have to suffer in silence. At Centers for Neurosurgery, Spine & Orthopedics, the award-winning surgical and non-invasive team offer expert spine care and joint care at multiple convenient locations across Northern NJ. With comprehensive physical therapy, pain management, and surgical services available, CNSO is uniquely equipped to treat patients with any type of neurological or musculoskeletal condition including any type of joint pain and spine disorder. To learn more about treatment options such as physical therapy, SI joint injections or sacroiliac joint fusion, contact CNSO today.