When it comes to sacroiliac joint (SIJ) fusion, there’s a growing tension between what we think we know and what science actually shows. In a world where innovation often outpaces understanding, one video dares to challenge the status quo. 

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But before you hit play, here are three critical truths you should know: 

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The SIJ Is Not a Simple Joint ​

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As the largest synovial joint in the axial skeleton, the SIJ is structurally complex — with thick cartilage endplates and a generous supply of synovial fluid. Yet, most devices currently used for SIJ fusion are small and intra-articular. This mismatch between joint scale and implant size may be why radiologic evidence for consistent fusion remains elusive. 

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Fusion ≠ Transfixation 

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We’ve seen a range of companies, Sacrix, Medtronic, SI-BONE, introduce titanium implants designed to transfix across the joint to promote fusion. These devices represent incredible feats of orthopedic engineering, but we must confront a deeper issue: 
Is it ethical to place non-retrievable devices in patients when long-term evidence is still evolving? 

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Sacrix: Engineering With Retrieval in Mind 

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Take Sacrix, for instance. Its implant boasts: 

• A complex, multithreaded matrix design 

• RBM surface texturing for better osseointegration 

• A posterior-to-anterior dual-implant technique to improve immediate stabilization 

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Approved by the FDA in 2015, Sacrix stands apart not just for its effectiveness (backed by peer-reviewed studies) but because it’s inserted percutaneously through an incision <1 inch and is fully retrievable.

 

 

It’s Time to End the Turf War 

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Whether you're an interventional pain specialist, orthopedic surgeon, or neurosurgeon, you can perform this technique safely. The question isn't who can do it. It's how we can ensure better outcomes for patients through thoughtful, evidence-backed approaches. 

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In the video, Dr. Kingsley R. Chin, Harvard-trained spine surgeon and innovator, offers a direct, no-nonsense look at the challenges and overlooked realities of SIJ fixation. His message is not just educational; it's transformative. 

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Don’t just follow the trend. Question it. Watch the video now: 

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Special thanks to Dr. Vasilios Kountis, DO, for the clinical imagery used in the discussion. While there is no perfect solution for every patient, the pursuit of better care demands open minds and honest dialogue.