Sacroiliac Joint Fusion Success

By Bruce E. Dall, MD

Question: In a sacroiliac joint fusion, can the joint fail to fuse and if so, what would be the outcome?

In a SI joint fusion, can the joint fail to fuse, and what would the outcome be like if this were to happen? What does the doctor do to help make sure mine will fuse? Can you please describe this, as I am confused about how this works. My surgeons said that the surgery does not create the fusion, but that the fusion takes place after the surgery, which I do not really understand. Also, what should I do on my part to make sure the fusion happens? I don’t want to go through the whole surgery only to have it not work. As you can tell, I am nervous and want to make sure that this surgery will work if at all possible!

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Doctor’s Response: There is about a 5% to 10% chance of failed sacroiliac joint fusion and further surgery may be needed to obtain a solid fusion.

Basically, a fusion procedure literally biologically welds two joints together. So, if a sacroiliac joint fusion is done correctly with success, then the sacrum becomes welded to the pelvis with bone. That bone comes from various sources, but the ideal source is your bone. Instrumentation is put down the joint and across the joint to stabilize the pelvis to the spine, and to allow the fusion to occur. Fusions take time. They do not occur immediately. The body has to go through a biological process where new cells are brought in and new bone cells are formed.

On average, this takes approximately twelve weeks to occur. During the first six weeks, the bone graft placed inside the joint develops a new blood supply, and during the second six weeks, it heals the way a fracture would heal. I tell my patients that there is a 5% to 10% chance that the fusion may not fuse solidly, and further surgery may be needed to get the fusion to be solid.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.