SI Joint Fusion

The sacroiliac (SI) joint is a joint that connects the hip bones to the sacrum, the triangular bone at the base of the spine. This joint absorbs a lot of the shock between the lower body and the torso. Inflammation of the SI joint due to arthritis or joint dysfunction can cause pain in the lower back, hip, pelvis, or groin.

If the SI joint is causing pain that affects your everyday life and nonsurgical treatments do not provide significant pain relief, SI joint fusion surgery may be an option. As a Harvard-trained trauma and pelvic surgery specialist, Dr. Riché has performed many procedures involving the pelvis and SI joint over the course of his career. He is also trained in minimally invasive techniques for SI joint fusion, which makes recovery much easier for patients.

When is SI Joint Fusion Recommended?

SI joint fusion may be helpful for patients with severe pain in the lower back, hip, or pelvis. This pain can interfere with daily activities like walking, sitting, and standing, and may limit mobility. Nonsurgical treatments are available to help manage symptoms, but if these treatments do not provide adequate pain relief, surgery may be an option.

Before Dr. Riché proceeds with an SI joint fusion, he must confirm that the SI joint is actually the source of pain. There are several conditions affecting the spine, pelvis, and hips that can produce similar symptoms. If the SI joint is not the source of a patient’s pain, then an SI joint fusion will not provide pain relief for that patient. Because he does not want to put patients through a procedure that may be unhelpful, he will not recommend an SI joint fusion until he has confirmed the source of the pain.

To confirm the source of pain, Dr. Riché sends his patients to a clinic for an arthrogram. During an arthrogram, contrast dye is injected into the SI joint under X-ray guidance for accuracy, followed by an injection of local anesthetic and steroid. If the injection provides pain relief, then Dr. Riché will receive confirmation from the clinic and provide his recommendation for SI joint fusion.

SI Joint Fusion Procedure

The goal of SI joint fusion is to fuse the sacrum to the hip bone, eliminating pain-causing motion in the joint. Dr. Riché uses minimally invasive techniques for this procedure, which makes recovery easier on patients and reduces the risk of complications. This procedure can also be done on an outpatient basis, so patients are able to go home the day of surgery.

To complete the procedure, Dr. Riché makes a small incision along the side of the buttock. He uses X-ray guidance to guide the surgical instruments to the correct location, then places three small triangle-shaped implants across the joint. These implants will fuse the joint together as you heal. The procedure is typically quick, often taking under 30 minutes to complete.

Minimally invasive SI joint fusion offers many benefits over the traditional, open procedure. Open SI joint fusion requires a much larger incision, and a bone graft is taken from the pelvis to fuse the joint. The procedure is typically much longer, and the recovery is more painful. Open procedures also have a higher risk of infection, because the incision is located directly above the center of the buttocks. In contrast, minimally invasive SI fusion has a smaller incision, does not require a bone graft, takes less time to complete, and the incision location minimizes the risk of infection.

Recovering from SI Joint Fusion

After the procedure is complete, patients are able to return home the same day. SI joint fusion typically provides very quick pain relief if the SI joint is the source of the patient’s pain. This is why Dr. Riché is very stringent about confirming the source of pain prior to surgery. In the right patients, SI joint fusion can provide excellent long-term results.

After surgery, patients will need to avoid putting weight on the affected leg for at least 4 weeks to allow the joint to fuse properly. During that time, patients may use a walker or crutches to get around. Physical therapy exercises can help patients gradually return to activity, starting with passive motion and stretching and gradually moving on to strengthening and weightbearing as the joint heals.

It can take several months for the bones to completely fuse together. Dr. Riché will advise when it is safe to return to normal activities. In most cases, once the bone has completely fused together, patients have no long-term restrictions.

SI Joint Fusion in Baton Rouge, LA

A Harvard-trained trauma and pelvic surgery specialist, Dr. Riché has extensive experience in pelvic surgery, including SI joint fusion. Using minimally invasive techniques, he is able to provide long-lasting pain relief for patients who have lower back, hip, or pelvic pain caused by SI joint dysfunction. If you think SI joint fusion may be right for you, please call our office at (225) 408-7939 to schedule a consultation with Dr. Riché, or use our convenient appointment request form.


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