Sacroiliac Joint Degeneration After Lumbopelvic Fixation

Nakashima, Hiroaki; Kanemura, Tokumi; Satake, Kotaro; Ito, Kenyu; Tanaka, Satoshi; Segi, Naoki; Ouchida, Jun; Kagami, Yujiro; Ando, Kei; Kobayashi, Kazuyoshi

doi:10.1177/2192568220978235

Cited by 4 publications

(12 citation statements)

References 28 publications

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“…According to the research performed, a total of 21 papers [6][7][8][13][14][15][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] met the inclusion criteria and were considered for review. Of these studies, 2 were prospective comparative studies, 24,32 1 was a prospective case series, 6 and 1 was a prospective cohort study.…”

Section: Included Studiesmentioning

confidence: 99%

“…Posterior (posterior spinal fusion), [6][7][8][13][14][15][21][22][23][24][26][27][28][30][31][32] anterior (anterior spinal fusion) [6][7][8]21,22,26,32 or combined (anterior plus posterior) 7,8,21 approaches were performed; only 3 studies did not specify data concerning surgical approach. 29,33,34 Regarding the number of fused levels, the included studies 13,27,31,34 reported a mean value between 1.39 ± 0.8 and 7.5 ± 3.3 with 920 1-level, 509 2-levels, 122 3-levels and 143 ≥ 4 levels procedures. The distinction between "fixed" fusion-in other words, an arthrodesis that includes sacrum -and "floating" fusion-an arthrodesis that does not include sacrum-was only described in 6 studies.…”

Section: Preoperative Diagnosis and Type Of Surgerymentioning

confidence: 99%

“…SIJ was evaluated clinically in 15, [6][7][8][13][14][15]23,[25][26][27][28][29][30][31]33 radiologically in 13 studies, 6,15,[20][21][22][23][24]26,27,29,31,33,34 both clinically and radiologically in 11 studies. 6,15,23,24,26,27,29,[31][32][33][34] The SIJ injection represents the gold standard diagnostic tool, if preceded by an accurate clinical examination and positive provocative tests. 6 The authors of 16 studies [6][7][8][13][14][15]23,[25][26][27]…”

Section: Sij Evaluationmentioning

confidence: 99%

“…Of these studies, 2 were prospective comparative studies, 24,32 1 was a prospective case series, 6 and 1 was a prospective cohort study. 25 In addition, there were 8 retrospective comparative studies, 8,13,14,23,28,29,31,34 4 retrospective case series, 7,20-22 3 retrospective cohort studies, 26,30,33 and 2 retrospective case-control study. 15,27 According to the Oxford level of evidence scale, 17 5 of the included studies had a level of evidence IV, 3 studies had a level of evidence II, while the remaining studies had a level of evidence III.…”

Section: Included Studiesmentioning

confidence: 99%

“…The most frequent diagnoses were stenosis (530 patients, 28.9%), spondylolisthesis (397 patients, 21.7%), and disk herniation (400 patients, 21.8%). In the other studies 7,8,15,20,22,25,33,34 the diagnosis was generic (ie, degenerative spine diseases or disorders) or not reported.…”

Section: Preoperative Diagnosis and Type Of Surgerymentioning

confidence: 99%

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Sacroiliac Joint Degeneration and Pain After Spinal Arthrodesis

Manzetti

Ruffilli

Barile

et al. 2022

Clinical Spine Surgery: A Spine Publication

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Study Design: This was a systematic review. Objective: The present study aims to review the available literature concerning sacroiliac joint (SIJ) pain and degeneration after lumbosacral fixation to identify the prevalence and potential risk factors. Summary of Background Data: Although numerous factors can predispose patients to SIJ degeneration and pain various clinical studies indicate lumbosacral arthrodesis as a major cause. Materials and Methods: The PubMed-MEDLINE, Cochrane Central Registry of Controlled Trials, and Embase Biomedical database were searched. Peer-reviewed comparative studies, cohort studies, case series studies and case control studies, conducted either in a retrospective or prospective design, that registered data about SIJ pain and degeneration after lumbosacral fixation were included. Results: Twenty-one studies including 2678 patients met the inclusion criteria. The percentage of SIJ pain after lumbosacral fixation diagnosed with injections and physical examination varied widely, from 3% to 90%. Among patients who underwent spinal fusion, SIJ pain prevalence was higher when arthrodesis was fixed compared with floating fusions (59% vs. 10%, P-value >0.05). The prevalence of SIJ degenerative changes at computed tomography scan was more frequent in patients who underwent spinal arthrodesis than in those who did not (75% vs. 38.2%, P-value ≤0.05). Conclusion: According to current evidence, patients who received lumbosacral fixation are at risk of SIJ pain. Number of fused levels, involvement of pelvis or sacrum in the arthrodesis area, inadequate lumbosacral sagittal alignment, and site of bone graft harvesting could be possible risk factor leading to sacroiliac degeneration and pain after lumbar spine fixation that should be investigated by physicians. However, there is a lack of homogeneity of the studies that address the problem, therefore, further prospective comparative studies, with a homogeneous architecture and cohorts are needed. Level of Evidence: Level III.

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