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SI Joint Fusion: Treatment for Sacroiliac Joint Pain

Do you have Sacroiliac (SI) Joint Pain?

The sacroiliac joint (SI joint), located in the pelvis and linking the pelvis to the sacrum (the lowest part of the spine above the tailbone), can be a significant cause of lower back pain. Clinical publications have identified the SI joint as a pain generator in 15-30% of chronic lower back pain patients.1-4 In addition, the SI joint is a pain generator in up to 43% of patients with continued or new onset lower back pain after a lumbar fusion.5

Sacroiliac Joint illustration
Illustration of pelvis SI joint pain

Like any other joint in the body, the SI joint can be injured and/or undergo degeneration. When this happens, people can feel pain in their buttock and sometimes in the lower back, hips and legs. This is especially true while lifting, running, walking or even lying on the involved side.

It’s common for pain from the SI joint to feel like disc or lower back pain, or sometimes hip or groin pain. For this reason, SI joint disorders should always be considered in lower back, hip, and pelvic pain diagnosis.

 

Do you experience one or more of the following SI Joint pain symptoms?

  • Lower back pain
  • Sensation of low extremity: pain, numbness, tingling, weakness
  • Pelvis/buttock pain
  • Hip/groin pain
  • Feeling of leg instability (buckling, giving way)
  • Disturbed sleep patterns due to pain
  • Disturbed sitting patterns (unable to sit for long periods, sitting on one side)
  • Pain going from sitting to standing
Woman on stair experiencing pain when stepping up

SI joint pain can mimic pain in the lower back, hip, groin or pelvis when stepping up.

Woman experiencing low back pain when transitioning from sitting to standing

Patients who suffer from SI joint dysfunction can have severe pain when performing transitional movements like standing from a chair.

Man experiencing low back pain shifting weight on hips

Patients who have SI joint pain usually find it difficult to sit for long periods of time, and usually try to alleviate the discomfort by sitting on the least effected side.

 Making a Diagnosis: What to Expect

The most relied upon method to accurately determine whether the SI joint is the cause of your lower back pain symptoms is to inject the SI joint with a local anesthetic. This diagnostic injection at iSpine Clinics is often performed under either X-ray guidance to verify accurate placement of the needle in the SI joint. If your symptoms decrease by at least 75%, it can be concluded that the SI joint is either the source of or a major contributor to your lower back, hip, or pelvic pain. If the level of pain does not change after SI joint injection, it is less likely that the SI joint is the cause of your pain.

 

SI Joint Fusion with iFuse TORQ® Implant System

iFuse TORQ® is designed to stabilize and fuse the SI joint. The iFuse procedure involves inserting typically three threaded titanium implants across the SI joint to maximize stability, reduce pain, and improve function. The procedure is done through a small one-inch incision and takes about an hour. The 3D-printed iFuse TORQ implant was designed for osseointegration, which is the structural and functional connection between implant and bone. This allows your painful joint to be stabilized through binding of bone all along the implant.6 

iFuse TORQ implant illustration in pelvis

iFuse TORQ® Implant System is one of the latest innovative solutions from SI-BONE, the creator of the minimally-invasive SI joint fusion device—the triangular titanium iFuse Implant. More than 100, peer-reviewed publications demonstrate the safety, durable effectiveness, and biomechanical and economic benefits of the iFuse implant (www.si-bone.com/results). The iFuse implant is the only SI joint fusion device with multiple prospective clinical studies, including two randomized controlled trials7,8, demonstrating that treatment improved pain, patient function, and quality of life.7-12 As with any minimally invasive surgical procedures, there are potential risks associated with the iFuse Implant System. It may not be appropriate for all patients and all patients may not benefit. For information about the risks, visit www.si-bone.com/risks.

Explore whether iFuse is right for you

The first step to finding out if you’re a candidate for the iFuse procedure is making an appointment at iSpine Clinics to review your case and discuss your options.

To make an appointment, call 763-201-8191.

Explore the Twin Cities Metro Clinics where we evaluate patients for SI Joint Pain

*iSpine Clinic locations where iFuse procedures are conducted

iSpine Clinic locations across the Twin Cities

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References

  1. Bernard TN, et al. Recognizing specific characteristics of nonspecific low back pain. Clin Orthop Relat Res. 1987;217:266–80.
  2. Schwarzer AC, et al. The Sacroiliac Joint in Chronic Low Back Pain. Spine. 1995;20:31–7.
  3. Maigne JY, et al. Results of Sacroiliac Joint Double Block and Value of Sacroiliac Pain Provocation Tests in 54 Patients with Low Back Pain. Spine. 1996;21:1889–92.
  4. Sembrano JN, et al. How Often is Low Back Pain Not Coming From The Back? Spine. 2009;34:E27–32.
  5. DePalma MJ, et al. Etiology of Chronic Low Back Pain Patients Having Undergone Lumbar Fusion. Pain Med. 2011;12:732-9.
  6. SI-BONE 300857-R.
  7. Polly DW, et al., and the INSITE Study Group. Two-Year Outcomes from a Randomized Controlled Trial of Minimally Invasive Sacroiliac Joint Fusion vs. Non-Surgical Management for Sacroiliac Joint Dysfunction. Int J Spine Surg. 2016;10:Article 28. DOI: 10.14444/3028
  8. Dengler J, et al. Randomized Trial of Sacroiliac Joint Fusion vs. Conservative Management for Chronic Low Back Pain Attributed to the Sacroiliac Joint. J Bone Joint Surg Am. 2019;101(5):400-11. DOI: 10.2106/JBJS.18.00022.
  9. Duhon B, Bitan F, Lockstadt H, Kovalsky D, Cher D, Hillen T, on behalf of the SIFI Study Group. Triangular Titanium Implants for Minimally Invasive Sacroiliac Joint Fusion: 2-Year Follow-Up from a Prospective Multicenter Trial. Int J Spine Surg. 2016;10:Article 13. DOI: 10.14444/3013
  10. Dengler J, et al. on behalf of the INSITE, iMIA and SIFI study groups. Predictors of Outcome in Conservative and Minimally Invasive Surgical Management of Pain Originating from the Sacroiliac Joint – a Pooled Analysis. Spine. 2017;42(21):1664-73. [Epub 2017 Mar 27]. DOI: 10.1097/BRS.0000000000002169
  11. Whang PG, et al. Long-Term Prospective Clinical and Radiographic Outcomes After Minimally Invasive Lateral Transiliac Sacroiliac Joint Fusion Using Triangular Titanium Implants. Med Devices (Auckl). 2019;12:411-422. DOI: 10.2147/MDER.S219862
  12. Patel V, et al. Prospective Trial of Sacroiliac Joint Fusion Using 3D-Printed Triangular Titanium Implants: 24-Month Follow-Up. Med Devices (Auckl). 2021;14:211-216. DOI: 10.2147/MDER.S314828
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