Pain Unfiltered · American Society of Pain & Neuroscience

The Exploration of Lateral SIJ Fusion

·35 min·2 clips

The device’s 12-millimeter depth and 10-millimeter wings are designed to keep the implant away from the S1 foramen.

The season closes on a procedural conversation. Patrick Buchanan and Timothy Deer review the span of Season 2, touching spinal cord stimulation, minimally invasive spine techniques, social media behavior, mentoring, and diversity before moving into the SI joint topic. The focus then narrows to lateral SI fusion. Buchanan asks about bleeding risk and why it has become part of the design conversation, and the guest answers with a safety frame drawn from reported complications. Bleeding is described as rare. The larger concern is foramen violation, treated as the complication the device design must actively avoid. The Liberty system becomes the center of the discussion. The guest explains that the device standardizes how far the implant travels past the SI joint, fixing that distance at 12 millimeters regardless of patient anatomy. The pin does the first job. A shoulder on the pin stops just outside the lateral cortex of the sacrum, then the remaining components slide over it to measure the ilium and guide a patient-specific implant choice. The design language stays practical. Buchanan relates the explanation to his own experience performing lateral SI fusions under general anesthesia with monitoring, where a breach toward the foramen would become apparent quickly. The exchange keeps returning to operator control. The hosts ask whether the short, standardized excursion past the joint line was intentional, and the answer confirms that it was built into the device to keep the implant farther from the foramen. Fit matters here. Because every pelvis and SI gap differs, the system is meant to preserve a consistent relationship to the sacrum while still matching the width of each patient's ilium. The conversation never drifts far from the procedure. It stays on anatomy, risk, and the small engineering choices that change where an implant sits in real tissue. The closing stretch turns back to the podcast itself. The hosts wrap the season, mention a London meeting in October, note that the next season starts in March, and invite sponsorship and subscriptions for listeners who want to keep following the series.

As heard by us

A practical look at how a lateral SI fusion system tries to limit a familiar procedural risk.

Pain Unfiltered spends this episode on lateral SI joint fusion, and the conversation stays focused on how the Liberty device is meant to make the procedure more controlled.

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Why you'd press play

You want the reasoning behind a more standardized lateral SI fusion.

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