Minimally Invasive SI Joint Stabilization

Minimally invasive SI joint stabilization is a minimally invasive surgery that stabilizes the sacroiliac joint (SI joint) to reduce pain and other related symptoms. For individuals who have had no significant or lasting success with nonsurgical treatments for SI joint pain, SI joint surgery can provide profound relief. Minimally invasive SI joint stabilization can improve symptoms and function with fewer risks than traditional open surgery.

Why Minimally Invasive SI Joint Stabilization Surgery?

  • Nonsurgical treatments have proven ineffective
  • Pain is interfering with your quality of life
  • Fewer risks and shorter recovery than traditional open surgery
  • Superior and quicker results than open surgery
  • Symptoms

  • Diagnosis

  • The Procedure


Individuals who need SI joint surgery may experience the following symptoms:

  • Dull or aching pain in the lower back and/or leg, typically limited to one side
  • Pain may be mild or severe
  • Pain that radiates through the hips, buttocks, groin, or back and side of the thigh
  • Hot, sharp, or stabbing pain in the buttocks and/or back of the thighs, sometimes including numbness and tingling (this can be similar to sciatic pain)
  • Worsening pain when lying on one side, climbing stairs, running, or jogging
  • Stiffness that reduces motion in the lower back, hip, and groin area
  • Instability/ feeling that the pelvis will buckle when standing, walking, or switching between standing and sitting

Frequently Asked Questions

Where is the SI joint?

The sacroiliac (SI) joint connects the hip bones to the sacrum, which is the triangular shaped bone between the tailbone and lower spine. This joint absorbs shock between the upper body and pelvis/legs. It is reinforced by strong ligaments, which assist with shock absorption and minimize movement of the joint. Excess movement is a sign of instability and usually causes pain that may radiate through the lower back, hip, and into the groin. Conversely, pathologic movement of the SI joint causes tension and pain that usually radiates from one side of the lower back or buttocks down the back of the leg.

What causes SI joint dysfunction? 

In many cases, SI joint pain arises gradually with no obvious cause. Still, there are several known causes of SI joint dysfunction. Scoliosis or discrepancies between leg lengths can cause gait issues that place uneven pressure on one side, which over time can wear down the SI joint. Pregnancy and childbirth can cause SI joint problems due to loosening ligaments, pelvic changes, hormonal changes, and weight gain. Strenuous labor jobs, heavy lifting, contact sports, and prolonged sitting or standing can lead to SI joint dysfunction. A previous history of lower back surgery (especially larger fusion surgery), as well as injury and inflammation, can also cause SI joint pain.

Are there nonsurgical treatment options for SI joint pain?

SI joint pain is initially treated with nonsurgical approaches. For many patients, a combination of the following nonsurgical treatments can eliminate pain:

  • Rest for 1 to 2 days
  • Apply ice and heat to the lower back and SI joint area
  • Pain medications, including over-the-counter pain relievers and anti-inflammatory medications
  • Prescriptive pain medications (for episodes of severe pain)
  • Physical therapy to facilitate normal motion (for SI joint pain caused by hypomobility)
  • Physical therapy to relieve pain, including stretching, strengthening exercises, and aerobic exercises
  • Pelvic brace (for SI joint pain caused by hypermobility)
  • Anti-inflammatory and steroid SI injections

A combination of treatments is usually necessary. If all nonsurgical treatments have been tried for a minimum of 6-12 weeks and proven ineffective, surgery may be recommended.

How does minimally invasive surgery compare to open surgery for SI joint stabilization?

The procedure for minimally invasive surgery is significantly shorter than open surgery and causes less blood loss and postoperative pain. It also has a shorter recovery because there is less damage to the surrounding tissues. Dr Pehler uses image guidance to further reduce the size of the incision and muscle trauma during surgery.

What are the risks of minimally invasive SI joint stabilization? 

As a minimally invasive surgery, this procedure has significantly lower risks than open surgery for SI joint stability. Some potential risks include failure to relieve symptoms, unsuccessful fusion of the joint, displaced pressure, and the need for revision surgery. The risks and benefits will be discussed with you before your procedure.

What is recovery like after minimally invasive SI joint stabilization?

Recovery from minimally invasive SI joint surgery is shorter than recovery after open surgery. Pain medication and at-home treatments applying heat and ice are recommended to reduce inflammation and discomfort. Physical therapy is usually performed during recovery.  Most patients are discharged home on the day of surgery, with some staying overnight for bilateral procedures.