Dr. Jordan Sudberg Explains Sacroiliac Joint Fusion: What You Need to Know About This Back Pain Procedure

Lower back pain is one of the most common causes of disability in the world, and in many cases, the culprit isn’t a herniated disc or muscle strain—it’s the sacroiliac (SI) joint. Located at the base of the spine where the sacrum meets the iliac bones of the pelvis, this small but powerful joint plays a critical role in supporting body weight and stabilizing movement.

When conservative treatments fail to relieve SI joint dysfunction, one option may be sacroiliac joint fusion—a minimally invasive procedure gaining attention for its ability to provide long-term relief.

We spoke with Dr. Jordan Sudberg, a board-certified pain management specialist, to break down what SI joint fusion is, how it works, and whether it’s the right choice for chronic pain sufferers.

What Is the Sacroiliac Joint?

The SI joint connects the sacrum—the triangular bone at the base of your spine—to the iliac bones, which make up the sides of the pelvis. There are two SI joints, one on each side.

Dr. Jordan Sudberg explains:

“The SI joint acts as a shock absorber and helps transfer weight between your upper body and legs. It allows for just a small amount of movement, but that motion is crucial for walking, bending, and standing.”

When the SI joint becomes dysfunctional, it can lead to intense lower back, buttock, and even leg pain. This condition is often referred to as sacroiliac joint dysfunction or sacroiliitis.

What Causes SI Joint Dysfunction?

SI joint dysfunction may be caused by:

• Pregnancy and childbirth, due to ligament relaxation
  
• Trauma or injury (e.g., car accidents, falls)
  
• Arthritis or degeneration of the joint
  
• Prior lumbar fusion surgery
  
• Leg length discrepancy or abnormal gait
  

Dr. Sudberg emphasizes that SI joint pain can mimic other conditions, which is why accurate diagnosis is essential.

“Many patients are misdiagnosed with sciatica or disc issues when the real source of their pain is the SI joint. A thorough clinical exam and diagnostic injections can confirm the true cause.”

Symptoms of SI Joint Dysfunction

Common symptoms include:

• Lower back pain, especially on one side
  
• Pain in the buttocks, hips, or groin
  
• Pain when sitting for long periods
  
• Pain when climbing stairs or getting out of a car
  
• Instability or “catching” sensation in the pelvis
  

Pain often worsens with activities like walking uphill or standing on one leg.

What Is Sacroiliac Joint Fusion?

Sacroiliac joint fusion is a surgical procedure designed to stabilize and immobilize the SI joint, eliminating painful motion. It typically involves inserting implants—usually small titanium screws or rods—across the joint to fuse the sacrum and ilium bones together.

Dr. Jordan Sudberg describes it as a minimally invasive option:

“SI joint fusion is often performed through a small incision, using specialized tools that minimize soft tissue damage. Patients are usually in and out the same day.”

The goal is to encourage bone growth across the joint, creating a solid fusion that prevents further irritation and pain.

Who Is a Candidate for SI Joint Fusion?

Not everyone with SI joint pain needs surgery. In fact, most people find relief through:

• Physical therapy
  
• SI joint injections
  
• Anti-inflammatory medications
  
• Radiofrequency ablation (nerve burning)
  

However, fusion may be recommended if:

• Pain persists for 6 months or longer
  
• Conservative treatments fail
  
• Diagnostic injections confirm the SI joint as the pain source
  
• The patient has had prior lumbar fusion, which increases SI joint stress
  

Dr. Sudberg advises:

“Surgery is a last resort, but for select patients, SI joint fusion can be life-changing. The key is careful screening and diagnostics to ensure it’s the right option.”

The Procedure: What to Expect

1. Preoperative Planning
Before the surgery, you’ll undergo imaging such as X-rays, CT scans, or MRI to assess joint alignment and rule out other issues.

2. The Surgery
Performed under general or spinal anesthesia, the procedure involves:

• A small (1–2 inch) incision near the buttock
  
• Insertion of guide wires and specialized instruments
  
• Placement of implants across the SI joint
  
• Closure of the incision with minimal stitches
  

The entire surgery usually takes less than an hour.

3. Recovery

• Most patients go home the same day.
  
• Limited weight-bearing for several weeks may be advised.
  
• Physical therapy typically begins within 6–8 weeks.
  
• Full recovery can take 3–6 months.
  

Dr. Sudberg emphasizes post-op care:

“Healing takes time. The fusion process relies on your body’s ability to grow bone across the joint, so patience and adherence to rehab protocols are crucial.”

Benefits and Success Rates

Numerous studies show high satisfaction rates with SI joint fusion. Patients often report:

• Significant pain reduction
  
• Improved walking and sitting tolerance
  
• Enhanced quality of life
  
• Return to work and daily activities
  

According to Dr. Sudberg:

“When performed on the right patient, SI joint fusion has success rates upwards of 80–90%. It offers hope to those who’ve exhausted other options.”

Risks and Considerations

As with any surgery, SI joint fusion carries potential risks, including:

• Infection
  
• Bleeding
  
• Nerve damage
  
• Implant failure
  
• Incomplete fusion or continued pain
  

However, minimally invasive techniques have greatly reduced complication rates. Dr. Sudberg reassures patients:

“The vast majority of patients recover smoothly. We always weigh the risks against the benefits, and ongoing follow-up is part of the process.”

Alternatives to Surgery

If you’re not ready for surgery, or want to explore other options first, Dr. Sudberg recommends:

• Guided physical therapy
  
• Targeted steroid injections
  
• SI joint belts/braces
  
• Radiofrequency ablation, which disables pain-carrying nerves
  

“For many, these treatments provide enough relief to avoid surgery altogether. Every case is unique, which is why personalized care is so important,” he says.

Final Thoughts: Is SI Joint Fusion Right for You?

Sacroiliac joint pain can be difficult to live with—but thanks to advancements in minimally invasive surgery, patients have more options than ever before. For those with persistent, confirmed SI joint dysfunction, sacroiliac joint fusion can offer lasting relief and renewed mobility.

Dr. Jordan Sudberg concludes:

“Our goal is to restore function and quality of life. If SI joint fusion is the right step, we walk with our patients through every stage—from diagnosis to recovery.”