Stabilizing the Sacroiliac Joint

Surgery might be an option to treat your sacroiliac (SI) joint dysfunction and limit the amount of movement of the sacroiliac joint. Your doctor may recommend a minimally invasive surgical procedure that fuses the SI joint.

Explanation of SI Joint Fusion Surgery - (01:13)

Dr. Carter Beck explains that SI joint fusion surgery is typically an outpatient procedure where patients go home the same day. Dr. Beck is a neurological surgeon at Montana Neurosurgical Specialists in Missoula, Montana.
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Rialto SI Fusion System

SI Joint Fusion System Rialto

The RialtoTM SI Fusion System is intended to stabilize your sacroiliac joint and provide an environment for fusion (joining bones together into one solid structure) to occur.

The Rialto SI fusion system consists of cylindrical threaded devices designed to enhance sacroiliac joint fusion. The threaded devices are offered in various lengths to accommodate your anatomy. For fusion of the SI joint, one, two, or three devices may be placed at your surgeon’s discretion.

Bone Model Demonstration of Surgery using Rialto SI Fusion System - (03:27)

Dr. Carter Beck uses a bone model to show the area where the surgery would take place and to describe placement of the Rialto SI fusion system. Dr. Beck is a neurological surgeon at Montana Neurosurgical Specialists in Missoula, Montana.
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Benefits of SI Joint Fusion

SI joint fusion with the Rialto SI fusion system has several advantages:

  • Physicians can use a minimally invasive approach through a small incision.
  • Insertion of the device causes minimal tissue disruption.
  • Bone graft can be delivered within the device to promote a fusion.

Risks of SI Joint Surgery

Potential risks in any surgical procedure include unforeseeable complications caused by anesthesia, blood clots, undiagnosed medical problems, such as silent heart disease, and rare allergic reactions. 

In addition, some risks of SI joint surgery include incomplete pain relief, damage to the nerve roots, infection, and complications with the hardware.

Most of these complications can be treated once they are detected, but sometimes they require a longer period of hospitalization or recovery, additional medications, and sometimes even additional surgery.

These risks will be explained by the primary surgeon. In general, these complications happen very infrequently, but it is important to remember that surgery is a difficult process, and, therefore, unforeseeable complications do occur. 

During Surgery

Your surgeon will perform the Rialto SI fusion procedure while you are under general anesthesia. The SI fusion is considered a minimally invasive procedure.

  1. Your surgeon will make a small incision above the buttock, just below your waist.  The incision will be slightly to the left or right of your spine, depending on the area to be treated.
  2. Through a series of steps, a cylindrical threaded device will be placed and packed with autograft and/or allograft to promote bone growth.
  3. Typically, but not always, two devices are placed to provide stability and promote fusion.

You should fully understand and follow your doctor’s advice so that the best possible outcome can be achieved.


Most SI fusion devices require the surgeon to perform the procedure from the side of your body, using a lateral approach. The Rialto SI fusion system uses a posterior approach to the SI joint, which means the surgeon enters from your back side. 


Muscles are disrupted with a lateral approach.


Minimal muscle disruption with a posterior approach.

Advantages of the posterior approach used with the Rialto SI fusion system include:

  • Easier access - the device passes through less tissue and muscle during the implantation
  • Less invasive - fewer muscles are disrupted during the procedure

Bone Model Explanation of the SI Joint Fusion Procedure using the Rialto SI Fusion System - (02:12)

Dr. David Rouben uses a bone model to describe the procedure used to stabilize the sacroiliac joint using the Rialto SI fusion system. Dr. Rouben is an orthopedic surgeon at Norton Spine Specialists in Louisville, Kentucky.
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If you have questions about the Rialto SI fusion system, please consult with your doctor, the only one qualified to diagnose and treat your condition.

Need help finding a doctor who is experienced in performing SI fusion surgery? Use our handy search tool.

pdf Rialto SI Fusion System Patient Brochure (.pdf)

Information about sacroiliac joint disease and SI joint fusion surgery using the Rialto SI fusion system.

pdf Doctor Discussion Guide  (.pdf)

Helps you clearly describe your symptoms to your doctor and ask questions that will help your doctor determine the treatment option that is best for you. Download and fill out the doctor discussion guide, and bring it to your next appointment.


Data is from a Medtronic survey conducted with physicians who are using posterior SI fusion approach and have previous experience in transgluteal/lateral SI fusion. Over 80% of the responding physicians stated that these attributes of a posterior approach were better compared to the transgluteal/lateral approach. The survey was not intended to compare specific products used.