If sacroiliac (SI) joint dysfunction has been identified as the cause of your chronic lower back pain or the persistent, sciatica-like pain that radiates through your hip, buttock, and leg, conservative treatment strategies are often the first line of defense.
However, if over-the-counter pain medication, physical therapy, anti-inflammatory injections, radiofrequency ablation, or other nonsurgical treatments don’t lead to effective pain relief and improved mobility after many months, SI joint fusion may be your best option.
In this blog, fellowship-trained neurosurgeon Jose Valerio, MD, discusses what’s involved in SI joint fusion and what you can expect as you recover from this minimally invasive procedure.
Understanding the SI joints
Your SI joints connect the base of your spine (sacrum) to your pelvic bone (ilium). You have two SI joints — one on each side of your sacrum — that connect your spine to the right and left sides of your hips.
Small, strong, and reinforced by tough supporting ligaments, your SI joints have a very limited range of motion. Their main function is to bear the weight of your upper body when you’re standing, and act as shock-absorbers for your spine as they transmit the forces of your upper body to your hips and legs.
The objectives of SI joint fusion
SI joint dysfunction is a common cause of chronic lower back pain, and sometimes, surgical treatment is the best solution. SI joint fusion surgery involves inserting a titanium implant and bone graft material to stabilize an unstable or hypermobile SI joint and promote new bone growth.
Dr. Valerio specializes in the most advanced minimally invasive (MIS) surgical technique for SI joint fusion — the iFuse Implant System® by SI Bone®. Done through a small incision in about an hour, this innovative method uses three small, triangular-shaped titanium implants to maximize SI joint stability and weight-bearing capacity.
Recovering from SI joint fusion
Most patients are released from the hospital the day after a minimally invasive SI joint fusion procedure. Because the bone around the joint fuses as you heal, it’s important to protect the joint, keep it stable, and minimize strain during post-surgical recovery.
Joint support and pain relief
To ease discomfort and reduce SI joint strain as the bone fuses and heals, your recovery plan may include:
- Walking with assistance (a cane, walker, or crutches) to minimize SI joint stress
- Avoiding weight-bearing activities for a prescribed amount of time (4-6 weeks)
- Wearing a pelvic brace (sacral belt) to stabilize the joint and facilitate healing
- Taking over-the-counter pain relievers to manage post-operative pain and sensitivity
- Using ice therapy to ease inflammation around the surgical site (low back, buttocks)
- Using heat therapy to ease muscle tension as you gradually become more active
Your personal postoperative weight bearing recommendations depend on your age, fitness level, balance ability, overall health, and musculoskeletal health. Some patients progress to full weight-bearing activities more rapidly than others.
The rehabilitation process
The entire recovery process for SI joint fusion surgery can take up to 6 months. An invaluable part of that process is physical therapy. Physical therapy involves designing a plan to restore function in your lower back and pelvis in a controlled, gradual way with minimal pain or discomfort. Your physical therapy plan could include:
- Passive range-of-motion stretches to gently relax tight hip and pelvic muscles
- Active stretching to restore full range of motion in the lower back, hips, and legs
- Balanced resistance exercises to improve core, lower back, and leg strength
- Aerobic (cardio) exercise to increase whole-body muscle activity and circulation
Dr. Valerio may also recommend aquatic therapy, which involves performing stretching and strengthening exercises in a warm pool, as part of your recovery process. Water provides natural resistance as well as buoyancy, making it an ideal environment for gentle, no-impact exercise.
Continued follow-up care
Throughout your recovery, you will have regular follow-up visits with Dr. Valerio, so he can ensure you're healing properly and assess your ongoing progress.
A high rate of excellent outcomes
SI joint fusion with the iFuse Implant System delivers exceptional clinical and patient results. Multiple clinical studies and randomized trials have shown that treatment with the triangular iFuse implant helps alleviate pain, improve function, and restore a better quality of life.
Within two years of undergoing SI joint fusion with iFuse, patient satisfaction remains high at 88%. The iFuse Implant System has been shown to reduce SI joint pain by 68%, improve back function by 50%, and decrease reliance on prescription opioids by 29%.
To learn more about minimally invasive SI joint fusion surgery, contact the practice of Jose Valerio, MD, to book an appointment. We have offices in South Miami, Hialeah, and Weston, Florida.