Sacroiliac joint fusion for chronic pain: a simple technique avoiding the use of metalwork


A previously undescribed method for posterior fusion of the sacroiliac joint (SIJ) utilizing the Cloward instrumentation is presented, suitable for cases with chronic pain and intact ligamental structures of the SIJ. The advantages of the method in comparison with other described options include minimal disturbance of the periarticular structures, avoidance of introduction of metalwork and preservation of the iliac crest contour. This technique has been used in five cases with follow-up longer than 2 years (mean 29 months, range 25–41 months). In all cases there was resolution of their painful symtomatology.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3a, b


  1. 1.

    Albert M, Miller M, MacNaughton et al. (1993) Posterior pelvic fixation using a transiliac 4.5 mm reconstruction plate: a clinical and biomechanical study. J Orthop Trauma 7:226–232

    CAS  PubMed  Google Scholar 

  2. 2.

    Balanger TA, Dall BE (2001) Sacroiliac arthrodesis using a posterior fascial splitting approach and pedicle screw instrumentation: a new technique. J Spinal Disord 14:118–124

    Article  PubMed  Google Scholar 

  3. 3.

    Cecil M, Rollins J, Ebraheim N et al. (1996) Projection of the S2 pedicle onto the posterolateral surface of the ilium. A technique for lag screw fixation of sacral fractures or sacroiliac joint dislocations. Spine 21:875–878

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    Dabezies E, Millet C, Murphy C et al. (1989) Stabilization of sacroiliac joint disruption with threaded compression rods. Clin Orthop 246:165–171

    PubMed  Google Scholar 

  5. 5.

    Dalstra M, Huiskes R (1995) Load transfer across the pelvic bone. J Biomech 28:715–724

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    Duwellius P, Van-Allen M, Bray T et al. (1992) Computed tomography-guided fixation of unstable posterior ring disruptions. J Orthop Trauma 6:420–426

    PubMed  Google Scholar 

  7. 7.

    Ebraheim N, Coombs R, Jackson W et al. (1994) Percutaneous computed tomography-guided stabilization of posterior pelvic fractures. Clin Orthop 307:222–228

    PubMed  Google Scholar 

  8. 8.

    Ebraheim N, Coombs R, Rusin J et al. (1992) Percutaneous CT-guided stabilization of complex sacroiliac joint disruption with threaded compression bars. Orthopaedics 15:1427–1430

    CAS  Google Scholar 

  9. 9.

    Fortin JD, Kissling RO, O’Connor BL, Vilensky JA (1999) Sacroiliac innervation and pain. Am J Orthop 28:687–690

    CAS  PubMed  Google Scholar 

  10. 10.

    Kellam J, McMurty R, Paley D, Tile M (1987) The unstable pelvic fracture. Orthop Clin North Am 18:25–41

    PubMed  Google Scholar 

  11. 11.

    Leighton R, Waddell J (1986) Techniques for reduction and posterior fixation through the anterior approach. Clin Orthop 329:115–120

    Google Scholar 

  12. 12.

    Magee DJ (1987) Pelvic joints. In: Magee DJ (ed) Orthopaedic physical assessment, 2nd edn. Saunders, Philadelphia, pp 308–332

  13. 13.

    Marcus R, Hansen S (1984) Bilateral fracture-dislocation of the sacrum. J Bone Joint Surg [Am] 66:1297–1299

    Google Scholar 

  14. 14.

    Matta J, Saucedo T (1989) Internal fixation of pelvic ring fractures. Clin Orthop 242:83–97

    PubMed  Google Scholar 

  15. 15.

    Mears D, Capito C, Deleeuw H (1988) Posterior pelvic disruption managed by the use of the double cobra plate. Instr Course Lect 37:143–150

    CAS  PubMed  Google Scholar 

  16. 16.

    Rand J (1985) Anterior sacro-iliac arthrodesis for post-traumatic sacro-iliac arthritis. J Bone J Surg [Am] 67:157–159

    Google Scholar 

  17. 17.

    Routt M, Simonian P (1996) Internal fixation of pelvic ring disruptions. Injury 27 (Suppl 2):B20–B30

    Article  PubMed  Google Scholar 

  18. 18.

    Routt M, Kregor P, Simonian P et al. (1995) Early results of percutaneous iliosacral screws placed with the patient in the supine position. J Orthop Trauma 9:207–214

    PubMed  Google Scholar 

  19. 19.

    Routt M, Simonian P, Inaba J (1994) Iliosacral screw fixation of the disrupted sacroiliac joint. Tech Orthop 9:300–314

    Google Scholar 

  20. 20.

    Routt M, Simonian P, Mills W (1997) Iliosacral screw fixation: early complications of the percutaneous technique. J Orthop Trauma 11:584–589

    PubMed  Google Scholar 

  21. 21.

    Simpson L, Waddell J, Leighton R et al. (1987) anterior approach and stabilization of the disrupted sacroiliac joint. J Trauma 27:1332–1339

    CAS  PubMed  Google Scholar 

  22. 22.

    Waisbrod H, Krainick JU, Gerbershagen HU (1987) Sacroiliac joint arthrodesis for chronic lower back pain. Arch Orthop Trauma Surg 106:238–230

    CAS  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to K. A. Giannikas.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Giannikas, K.A., Khan, A.M., Karski, M.T. et al. Sacroiliac joint fusion for chronic pain: a simple technique avoiding the use of metalwork. Eur Spine J 13, 253–256 (2004).

Download citation


  • Sacroiliac joint
  • Fusion
  • Chronic pain