“Sacroiliac joint fusion is a treatment for lower back and pelvis pain. The sacrum and ilium are formed by fusion procedure. If conservative treatment methods don’t help the back pain, surgical treatments in the form of a sacroiliac joint fusion may be able to.”

Doctors can perform the surgery using a minimally-invasive approach thanks to innovations in sacroiliac joint fusion. You can learn about how and for who a sacroiliac joint fusion can help.

Researchers estimate 15 to 30 percent of all lower back pain experiences are due to sacroiliac joint dysfunction. This is likely because the sacroiliac joint is responsible for helping you bend and also withstands pressure while doing so, transferring force and pressure from your lower back to your legs.

The sacroiliac joint is vulnerable to injury and can lead to pain. This surgery is to reinforce the joint and reduce the pain.

In addition to pain relief, other benefits of a sacroiliac joint fusion include:

  • Better quality of life.
  • The daily function has been enhanced.
  • Reduced disability.

Adverse side effects aren’t usual following a sacroiliac joint fusion, but the most common risks of sacroiliac joint fusion are:

  • There is a new-onset back pain.
  • The trochanteric bursitis is a hip pain.
  • The wound was wounded up.
  • The bone is broken.
  • The failure of the bone to heal is called nonunion.

Other potential, but less common, side effects include:

  • There was bleeding.
  • A hematoma is a collection of blood.
  • Nerve pain.
  • Blood clot in your lungs.

The ability to perform the surgery in a minimally invasive fashion has helped to improve outcomes and reduce serious effects.

sacroiliac joint fusion can be done using an open or minimally-invagant approach.

Illustration by Jason Hoffman

Open Approach

Although there are different techniques, an open surgical procedure involves:

  • A person goes to sleep under general anesthesia, unaware that they are having surgery.
  • The surgeon makes an open cut in the back.
  • A block of bone is removed to access the sacrum.
  • The surgeon removes the sacrum.
  • Plates and screws are used to fix the bone in place after a block of bone is replaced.

Surgeons may also opt to perform sacroiliac joint fusion as a minimally invasive surgery. Advancements in equipment have meant the surgery doesn’t have to require a large incision or prolonged recovery times.

Minimally invasive approach

The steps for a minimally invasive sacroiliac joint fusion are similar and may include:

  • The patient is in the hospital.
  • They sleep under general anesthesia, unaware of the procedure taking place.
  • A surgeon makes a small, 3- to 5-centimeter incision on the side of the buttock.
  • The surgeon uses a scalpel to cut through the muscles of the upper portion of the pelvis.
  • A surgeon uses a guide pin to access the ilium and drill to pass implants to the sacrum.
  • The surgeon guides the instruments through the passage. The implants are secured using screws and pins.
  • The surgeon uses water and a solution of water and salt to clean the surgical site. They close the wound with sutures.

The Medicare code for sacroiliac joint fusion surgery is 27279. You may have to get precertification before you can have the surgery, but insurance companies will usually cover it. The cost of this surgery depends on where the surgeon performs it.

If the surgery takes place at an ambulatory surgery center, the patient typically pays $2,769, according to Medicare. If the surgery is at a hospital outpatient department, the patient typically pays $1,661. However, your costs may vary based on your location, health needs, and surgeon fees.

When the procedure is done in a minimally-invasive fashion, surgeons will encourage you to get up and walk around quickly. You may need an ambulatory assist device to avoid excessive pressure on the site.

Surgeons will typically recommend limiting weight-bearing activity (how much heavy stuff you hold and move) for up to 6 weeks after surgery. However, some doctors may recommend avoiding heavy lifting for up to 12 weeks after surgery to ensure the bone and surgical implants are appropriately healing.

Doctors may recommend activity limitations that include not lifting more than 10 pounds or bending at the waist excessively. You can return to physical activity after 6 months after surgery, but a surgeon may recommend follow-up scans.

Sacroiliac joint fusion seems to be more effective in some people and less effective in others. The surgery seems to be most effective in:

  • Older adults have had back pain for a long time.
  • Patients who have never had spine surgery.

The surgery seems to be less effective in:

  • Those who take the most pain medication.
  • Those who smoke.
  • those who’ve undergone previous spinal fusion

A doctor will study your symptoms to determine if the surgery will relieve your pain.

While you may not experience complete pain relief after sacroiliac joint fusion surgery, people do typically experience significant pain relief that lasts 5 years or more.

Lower back pain can be caused by sacroiliac joint problems. Sacroiliac joint fusion can be done with a minimally-invasive approach.

If you have lower back pain that is not helped by conservative measures, you should talk to a doctor about a possible treatment approach.