SI Joint Fusions

Direct answers — no jargon.

If your question isn’t here, ask us at your consultation. We will give you the same answer in plain English.

• Is this a major spine surgery?
  Modern SI joint fusion is decidedly minimally invasive — performed through small incisions, typically under sedation rather than general anesthesia, with most patients home the same day. It is a different procedure from traditional open lumbar fusion.
• Will I lose mobility in the joint?
  The SI joint has very limited normal motion to begin with — a few millimeters of glide. Stabilizing it does not meaningfully restrict your overall function. In practice, most patients report increased mobility because they are no longer guarding around the painful joint.
• How will I know if my SI joint is the source?
  We confirm SI joint pain through diagnostic injections — typically two separate injections on different visits — that must each provide significant temporary relief. We do not proceed with fusion unless the diagnostic case is solid.
• Which fusion system will you use?
  Dr. Baumgartner uses more than one SI fusion system and graft type — including allograft and implant-based options — and selects for each patient based on anatomy, prior surgeries, and the specific imaging findings. We discuss the choice with you before the procedure.
• Which approach will you use — posterior oblique, lateral, or posterior?
  Dr. Baumgartner performs SI joint fusion through all three approaches: posterior oblique, lateral, and posterior. Each takes a different path to the joint and carries a different anatomic profile, so the approach is chosen for your anatomy, prior surgeries, and imaging rather than by which technique the practice happens to offer. We discuss the options with you before scheduling.
• What is recovery like at 6 weeks?
  By six weeks, most patients have returned to normal walking, light work, and most daily activities. Heavy lifting and high-impact activity are typically held until the 12-week mark to give biological fusion time to mature.
• Will I see fusion on imaging right away?
  No. Mechanical stability is immediate after the procedure, but biological fusion (bone bridging across the joint) develops over months. We confirm fusion progress with imaging at six and twelve months.
• I had a previous lumbar fusion. Is SI fusion still appropriate?
  Yes — and post-lumbar-fusion SI joint pain is one of the most common and underdiagnosed presentations we see. The SI joint takes on additional stress after lumbar fusion, and many patients who feel like the lumbar fusion 'failed' are actually dealing with SI joint dysfunction.
• Will the implant set off airport metal detectors?
  Implant-based SI fusion systems are typically below the threshold of standard airport metal detectors, and allograft-only fusions contain no metal. When an implant is used, its manufacturer supplies an implant card you can carry in your wallet for reference if needed.
• What if the fusion doesn't work?
  Failure to fuse is uncommon but possible. If the joint does not progress to fusion or pain returns, we have options — revision, additional fixation, or alternative therapies including spinal cord stimulation. We do not abandon patients to their pain.