AI Article Synopsis
- Sacroiliac joint hypermobility can cause pain, and this study aimed to evaluate its range of motion after lumbosacral fusion surgeries, with or without additional sacroiliac joint fusion.
- The study was conducted using seven cadaver specimens and involved severing specific ligaments to test the influence of surgical instrumentation on sacroiliac joint motion.
- Findings revealed that joint injury led to an increase in range of motion, but stabilizing the joint with lateral sacroiliac screws significantly reduced that motion, indicating that screw configuration is important for controlling joint function post-surgery.
Article Abstract
Background: Sacroiliac joint hypermobility or aberrant mechanics may be a source of pain. The purpose of this study was to assess sacroiliac joint range of motion after simulated adjacent lumbosacral instrumented fusion, with or without sacroiliac joint fusion, with lateral sacroiliac screws.
Methods: In this in vitro biomechanical study, seven cadaveric specimens were tested on a six-degrees-of-freedom machine under load control. Left posterior sacroiliac joint ligaments were severed to maximize joint range of motion. Influence of lumbosacral instrumentation on sacroiliac joint motion, with or without fixation, was studied.
Findings: During flexion-extension in the setting of posterior sacroiliac joint injury and L5-S1 fixation, sacroiliac joint range of motion increased to 195% of intact. After fixation with lateral sacroiliac screws, average range of motion reduced to 144% of intact motion. Sacroiliac joint screws thus partially stabilized the joint and reduced motion. Use of 6 bilateral sacroiliac joint screws with L5-S1 screw and rod fixation in lateral bending and axial rotation yielded the greatest reduction in range of motion. Without lumbosacral fixation, baseline motion of the sacroiliac joint was reduced, and sacroiliac joint screw alone, using either 2, 3, or 6 screws, was able to restore motion at or below the level of an intact joint.
Interpretation: Sacroiliac joint ligament injury with existing lumbosacral fixation doubled sacroiliac joint range of motion, but thereafter, fixation with lateral sacroiliac screws decreased range of motion of the injured sacroiliac joint. Screw configuration played a minor role, but generally, 6 sacroiliac joint screws had the greatest motion reduction.
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| http://dx.doi.org/10.1016/j.clinbiomech.2019.05.025 | DOI Listing |
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