Sacroiliac joint fusion (open) is a surgical procedure used to stabilize and relieve pain in the sacroiliac joint, which is located between the spine and the pelvis. It’s typically recommended when other treatments haven’t worked, especially in cases of trauma, infection, cancer, or spinal instability.

In this surgery, a larger incision is made in the lower back to access the joint. The surgeon removes the joint’s cartilage and may use bone grafts—either from the patient (called an autograft) or from a donor (an allograft)—to help the bones fuse together. Screws or rods are then placed to keep the joint stable while it heals and fuses.

This procedure can relieve chronic lower back pain, discomfort in the buttocks, or pain that radiates down into the legs. These symptoms often stem from joint degeneration, injury, or instability. Before surgery, doctors usually recommend conservative treatments like physical therapy, steroid injections, bracing, and other pain management methods.

There are also less invasive alternatives, such as the percutaneous approach, which uses implants and smaller incisions and often allows for a quicker recovery. However, the open surgery may be necessary when more extensive stabilization is needed.

As with any major surgery, there are risks—including increased blood loss, infection, nerve damage, and a longer recovery. Most patients stay in the hospital for 2 to 3 days and may need 6 to 12 months for full recovery. During this time, it’s important to avoid strenuous activities.

This surgery may help relieve symptoms like ongoing lower back pain near the SI joint, pain that spreads to the buttocks, hips, or groin, and difficulty standing, sitting for long periods, or climbing stairs. The open approach may be the best option for certain cases—talk to our team to find what’s right for you.