3 The procedure
3.1 Minimally invasive surgical fusion of the sacroiliac (SI) joint is done with the patient under general or spinal anaesthesia and in a prone position. Fluoroscopic guidance is used. Using a lateral transarticular approach, the SI joint is accessed laterally through a small incision made in the buttock to reach the ilium. A pin is passed through the ilium across the SI joint into the centre of the sacrum, avoiding the neural foramen. A drill is then used to create a pathway through the ilium to the sacrum. An implant is inserted (with the lateral portion of the implant sitting in the ilium and the medial end in the sacrum), spanning the SI joint. Typically, 3 implants are used.
3.2 Treatment of both SI joints can be done at the same time, or in staged procedures. After surgery, patients are advised to make a gradual return to full weight bearing over several weeks, using a walker for assistance, and then have physiotherapy.