Pain Unfiltered · American Society of Pain & Neuroscience

The Current State of SIJ Fusion

April 7, 2025·39 min·4 clips

Patrick Buchanan opens the show and welcomes Tim Deer back for a new season. They frame Pain Unfiltered as a close-up look at the interventional pain and spine world. The discussion quickly turns to Aspen's July conference, with the July 17th through 20th meeting highlighted as a major gathering. The science agenda is broad. It covers new advances in MIS, cadaver-based training, neuromodulation, evidence creation, study design, and information from the FDA. From there, the conversation narrows into SI joint fusion. The speakers stress that the device should be built to achieve fusion, not simply to match a code description. They use older implant history as a warning sign. A seven millimeter partially threaded screw from the 1990s is cited as an approach that did not hold up well. Newer ideas like plasma-sprayed implants and threaded implants are measured against that history. The point is framed through AO principles of fusion. The code description is treated as something the device should match, not the other way around. The show then walks through the regulatory landscape. It distinguishes between 361 cortical allografts and 510(k) predicate devices. The 361 pathway is described in terms of human cellular tissue, minimally manipulated homologous use, and placing graft where bone already exists. The 510(k) route is presented as the familiar predicate-device path for SI fusion products. The hosts note how crowded the field has become, with over 50 companies in the space. Patient selection comes into view as the next major question. Jeff Donner is mentioned as a longtime voice in the area and someone with deep experience. The episode closes with a call for collaboration, conference participation, and listener questions, along with an invitation to reach out or sponsor the season. It leaves the sense that SI joint fusion now sits at the point where clinical judgment, device engineering, and patient selection all have to line up.

As heard by us

A focused SI fusion discussion about devices, coding, and patient fit.

Pain Unfiltered opens its third season with a clear, practical look at SI joint fusion, moving through device design, coding, and the basic problem of getting fusion right.

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Why you'd press play

If you care how SI fusion gets designed, coded, and defended, start here.

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