Best practices for the LinQ sacroiliac joint stabilization procedure for the treatment of sacroiliac joint disorders

Sacroiliac joint (SIJ) disease is a common source of low back and buttock pain and is often linked to prior lumbar fusion, pregnancy, trauma, or repetitive loading. Because conservative measures such as injections and radiofrequency can be short-lived, interest has shifted toward minimally invasive SIJ fusion.

This review summarizes SIJ diagnosis, workup, and patient selection for fusion, and focuses on posterior allograft fixation, including procedural steps, postoperative care, outcomes, complications, and limitations.

Modern SIJ fusion first gained momentum with lateral transfixing implants. Additional developments included the method of lateral oblique placement, with a theory of being higher in the sacrum to avoid the neural structures and arterial supply to the gluteal muscles. Posterior intra-articular allograft fixation (LinQ; PainTEQ) may reduce exposure to major vessels and nerves, can be performed in office or outpatient settings, and may be easier to adopt because access and imaging resemble SIJ injection. Available studies suggest meaningful pain and functional improvement. We view posterior intra-articular allograft fixation as appealing for osteoporosis, where transfixing implants are less desirable, and we recommend registry data plus randomized trials to refine selection and comparative effectiveness.