Evaluation of a minimally invasive procedure for sacroiliac joint fusion &amp;ndash; an in vitro biomechanical analysis of initial and cycled properties

Lindsey, Derek P.; Pérez-Orribo, Luis; Rodriguez-Martinez, Nestor G.; Reyes, Phillip M.; Newcomb, Anna G.; Cable, Alexandria; Hickam, Grace; Yerby, Scott A.; Crawford, Neil R.

doi:10.2147/mder.s63499

Cited by 47 publications

(69 citation statements)

References 29 publications

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“…Our results on SIJ flexion-extension rotation have been markedly different concerning translation compared with previous trials (Weisl, 1955;Egund et al 1978;Miller et al 1987;Sturesson et al 1989Sturesson et al , 1999Sturesson et al , 2000aVleeming et al 1989;Kissling et al 1990;Simonian et al 1994b;Jacob & Kissling, 1995;Kibsg ard et al 2012Kibsg ard et al , 2014b. Especially, in vitro studies appear to overestimate the extent of motion (Vleeming et al 1992a,b;Lindsey et al 2014), potentially as a consequence of un-physiological loading or of limiting the multi-axial nutation of the SIJ to one or two planes with direct force application onto the sacral promontory. SIJ rotations beyond 2°are unlikely to appear under physiological conditions according to our given experiments.…”

Section: Posterior Pelvis Biomechanics Revisited Combining Physiologicontrasting

confidence: 73%

“…A number of studies have made attempts to describe SIJ movements both qualitatively and quantitatively (Weisl, 1955;Egund et al 1978;Lavignolle et al 1983;Miller et al 1987;Rothk€ otter & Berner, 1988;Sturesson et al 1989Sturesson et al , 1999Sturesson et al , 2000aVleeming et al 1989Vleeming et al , 1992aSimonian et al 1994a;Jacob & Kissling, 1995;Kissling & Jacob, 1996;Wang & Dumas, 1998;Kibsg ard et al 2012Kibsg ard et al , 2014bLindsey et al 2014). The common observation is that its overall movement is multi-dimensional and held within a small range, but to a highly variable extent among individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, an evaluation of the deformation related to both absolute loading (in N) and bodyweight (in %) (Wang & Dumas, 1998) provided realistic data which can be used for reference or numerical validation purposes. Previous SIJ biomechanical setups were commonly limited to the sacrum and ilium, either isolated from the remaining pelvis (Miller et al 1987;Rothk€ otter & Berner, 1988;Bechtel, 2001) or in a uniaxial loading setup with one of the joint partners firmly attached (Simonian et al 1994b;Wang & Dumas, 1998;Bruna-Rosso, 2014;Lindsey et al 2014). This previous approach likely limited the interpretability of the movements, as, in vivo, both joint partners have a certain degree of freedom within the kinematic chain.…”

Section: Posterior Pelvis Biomechanics Revisited Combining Physiologimentioning

confidence: 99%

“…This complex interplay maintains both form and force closure at the pelvis, but makes it impossible to examine the SIJ independently, as the overall motion is multi-segmental. Previous studies limiting this multi-segmental motion may therefore lack in interpretability (Simonian et al 1994b;Wang & Dumas, 1998;Bruna-Rosso, 2014;Lindsey et al 2014).…”

Section: Introductionmentioning

confidence: 99%

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Physiological in vitro sacroiliac joint motion: a study on three‐dimensional posterior pelvic ring kinematics

et al. 2018

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The sacroiliac joint (SIJ) is a well-known source of low back and pelvic pain, of increasing interest for both conservative and surgical treatment. Alterations in the kinematics of the pelvis have been hypothesized as a major cause of SIJ-related pain. However, definitions of both the range and the extent of physiological movement are controversial, and there are no clear baseline data for pathological alterations. The present study combined a novel biomechanical setup allowing for physiological motion of the lumbosacral transition and pelvis without restricting the SIJ movement in vitro, combined with optical image correlation. Six fresh human pelvises (81 AE 10 years, three females, three males) were tested, with bodyweight-adapted loading applied to the fifth lumbar vertebra and both acetabula. Deformation at the lumbopelvises was determined computationally from three-dimensional image correlation data. Sacroiliac joint motion under the loading of 100% bodyweight primarily consisted of a z-axis rotation (0.16°) and an inferior translation of the sacrum relative to the ilium (0.32 mm). Sacroiliac joint flexion-extension rotations were minute (< 0.02°). Corresponding movements of the SIJ were found at the lumbosacral transition, with an anterior translation of L5 relative to the sacrum of À0.97 mm and an inferior translation of 0.11 mm, respectively. Moreover, a flexion of 1.82°was observed at the lumbosacral transition. Within the innominate bone and at the pubic symphysis, small complementary rotations were seen around a vertical axis, accounting for À0.10°and 0.11°, respectively. Other motions were minute and accompanied by large interindividual variation. The present study provides evidence of different SIJ motions than reported previously when exerted by physiological loading. Sacroiliac joint kinematics were in the sub-degree and sub-millimeter range, in line with previous in vivo and in vitro findings, largely limited to the sagittal rotation and an inferior translation of the sacrum relative to the ilium. This given physiological loading scenario underlines the relevance of the lumbosacral transition when considering the overall motion of the lumbopelvis, and how relatively little the other segments contribute to overall motion.

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Section: Posterior Pelvis Biomechanics Revisited Combining Physiologicontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Posterior Pelvis Biomechanics Revisited Combining Physiologimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Physiological in vitro sacroiliac joint motion: a study on three‐dimensional posterior pelvic ring kinematics

et al. 2018

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“…Again, though this model has only been validated partially, it formed basis for further FE models, again with vastly different loading scenarios, e.g. on leg length discrepancy (Kiapour et al, 2012) or on surgical SIJ fusion (Lindsey et al, 2014). Another set of literature-based validation attempts can be found for these two studies, all with different load application (Goel et al, 1978;Miller et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

Hammer

Klima

2019

Clinical Biomechanics

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Instrumentation of the sacroiliac joint with cylindrical threaded implants: A detailed finite element study of patient characteristics affecting fixation performance

Dubé-Cyr

Villemure

Arnoux

et al. 2021

Journal Orthopaedic Research

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The sacroiliac joint (SIJ) is a known pain generator that, in severe cases, may require surgical fixation to reduce intra-articular displacements and allow for arthrodesis.The objective of this computational study was to analyze how the number of implants affected SIJ stabilization with patient-specific characteristics such as the pelvic geometry and bone quality. Detailed finite element models were developed to account for three pelvises of differing anatomy. Each model was tested with a normal and low bone density (LD) under two types of loading: compression only and compression with flexion and extension moments. These models were instrumented with one to three cylindrical, threaded and fenestrated implants through a posterior oblique trajectory, requiring less muscle dissection than the more common lateral trajectory used with triangular implants. Compared with the noninstrumented pelvis, the change in range of motion (ROM) and stress distribution were used to characterize joint stabilization. Noninstrumented mobility ranged from 0.86 to 2.55 mm and from 1.37°to 6.11°. Across patient-specific characteristics, the ROM reduction with one implant varied from 3% to 21% for vertical and 15% to 47% for angular displacements. With two implants, the ROM reduction ranged from 12% to 41% for vertical and from 28% to 61% for angular displacements. Three implants, however, did not further improve the joint stability (14% to 42% for vertical and 32% to 63% for angular displacements). With respect to patient characteristics, an LD led to a decreased stabilization and a higher volume of stressed bone (>75% of yield stress). A better understanding of how patient characteristics affect the implant performance could help improve surgical planning of sacroiliac arthrodesis.

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Evaluation of a minimally invasive procedure for sacroiliac joint fusion – an in vitro biomechanical analysis of initial and cycled properties

Cited by 47 publications

References 29 publications

Physiological in vitro sacroiliac joint motion: a study on three‐dimensional posterior pelvic ring kinematics

Physiological in vitro sacroiliac joint motion: a study on three‐dimensional posterior pelvic ring kinematics

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

Instrumentation of the sacroiliac joint with cylindrical threaded implants: A detailed finite element study of patient characteristics affecting fixation performance

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