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Advanced Procedures · Treatment

Sacroiliac Joint Fusion

A procedure that permanently stabilizes the joint connecting the base of the spine to the pelvis, reserved for SI joint pain confirmed by diagnostic injection that hasn't responded to injections, physical therapy, or ablation. Modern fusion is minimally invasive, and most patients go home the same day.

Spine models being used to explain Sacroiliac Joint Injections
Performed By
Faisal Lalani
Nadiv Y. Samimi
Faisal Lalani, MD & Nadiv Y. Samimi, MD MD
Last reviewed · June 8, 2026
AT A GLANCE

Sacroiliac joint fusion at PHI is performed by board-certified physicians Dr. Faisal Lalani and Dr. Nadiv Samimi in our affiliated surgical suite at 455 N Roxbury Drive, Suite B, Beverly Hills. A minimally invasive procedure that permanently stabilizes the sacroiliac joint, it is reserved for confirmed SI joint pain that has not responded to injections, physical therapy, and RFA.

What SI Joint Fusion Is

Sacroiliac joint fusion is a procedure that permanently stabilizes the sacroiliac joint, the joint connecting the base of your spine to your pelvis. It is reserved for patients whose SI joint pain has been confirmed through diagnostic injection and who have not responded adequately to non-surgical treatments including injections, physical therapy, and radiofrequency ablation.

Modern SI joint fusion is meaningfully different from older fusion approaches. It is performed minimally invasively through small access points using specialized implants designed for SI joint stabilization. Most patients are home the same day or after a brief stay.

How the Procedure Works

The procedure is performed in our affiliated surgery center under image guidance and propofol sedation. The physician advances specialized implants across the SI joint through small access points. The implants stabilize the joint and promote bone fusion across the joint surfaces over the months following the procedure.

The procedure typically takes about an hour. Most patients leave the same day or after a brief observation period.

Who Is a Candidate

SI joint fusion is typically appropriate for patients who:

  • Have confirmed SI joint pain through positive diagnostic injections
  • Have not responded adequately to non-surgical treatments including injections, physical therapy, and radiofrequency ablation
  • Have a pain pattern, exam findings, and imaging that all support SI joint involvement
  • Are otherwise medically appropriate for a surgical procedure
  • Understand the procedure is irreversible and have realistic expectations

Most patients with SI joint pain do not need fusion; most are managed effectively with injections, RFA, and other interventions. Fusion is reserved for the subset whose pain has not adequately resolved with non-surgical care.

What the Evidence Shows

Modern minimally invasive SI joint fusion has accumulating evidence for appropriately selected patients. Multiple randomized controlled trials and prospective cohort studies have demonstrated meaningful pain reduction, functional improvement, and quality-of-life gains compared to non-surgical management for patients meeting strict candidacy criteria.

Patient selection is the dominant factor in fusion success. Patients without confirmed SI joint pain or with multiple competing pain generators have lower success rates, so careful evaluation before recommending fusion is essential.

Why Patients Choose PHI for SI Joint Fusion

01

Convenient surgery center

SI joint fusion requires sedation and a proper procedural environment. PHI performs the procedure in our affiliated surgery center at 455 N Roxbury Drive, Suite B.

02

Two board-certified physicians

Treatment is performed by Dr. Faisal Lalani or Dr. Nadiv Samimi, both fellowship-trained at Cedars-Sinai.

03

Conservative-first approach

PHI does not recommend SI joint fusion as a first-line treatment. We exhaust non-surgical options including injections and RFA before recommending fusion. When fusion is recommended, it is because non-surgical approaches have been thoroughly tried.

04

Diagnostic-to-therapeutic continuity

The same physicians who performed your SI joint injections and RFA evaluate you for fusion. This continuity ensures the decision to proceed is based on full knowledge of your treatment-response history, not a fresh assessment from a new provider.

05

Concierge, coordinated care

Single-physician continuity from consultation through treatment and return to activity. Patients receive clear guidance and transparent pricing at consultation.

What to Expect

Before

Preparation

Your physician confirms candidacy based on diagnostic injection response, imaging, exam findings, and treatment history. Some medications must be paused; you will receive specific instructions.

During

The procedure

The procedure takes approximately one hour under propofol sedation. The physician advances specialized implants across the SI joint through small access points.

After

Recovery

You rest in our recovery area. Most patients leave the same day or after a brief observation period, and you will need transportation home.

First 6 weeks

Early recovery

Activity restrictions are significant during the early recovery period to allow the fusion process to begin. Most patients use crutches or a cane for partial weight-bearing initially, and physical therapy typically begins within several weeks.

3 to 6 months

Fusion progresses

Bone fusion across the joint typically progresses meaningfully during this period. Most patients are gradually returning to most normal activities, with continued progression toward full activity.

Beyond 6 months

Final outcome

Most patients experience continued improvement in pain and function. Final outcomes are typically established by 12 to 24 months post-procedure.

Frequently Asked Questions

Begin a consultation

Schedule with PHI.

A 60-minute consultation includes history, imaging review, and an honest discussion of whether interventional or regenerative care is the right next step for you.