Influence of Spinopelvic Parameters on the Development of Sacroiliac Joint Pain Syndrome and Efficacy of Its Treatment

Abstract

Purpose: to study the influence of spinopelvic parameters on the risk of sacroiliac joint (SIJ) dysfunction development and prognosis of its treatment in patients with degenerative-dystrophic diseases of lumbosacral spine. Patients and methods. Prospective nonrandomized study included 197 patients: 79 patients with SIJ syndrome verified by the test block (main group) and 118 patients with other causes of low back pain (control group). In the main group the treatment tactics consisted of intraarticular injections of glucocorticosteroids and radiofrequency SIJ denervation. The result was deemed positive when pain intensity reduction made up 50% by Numerical Rating Scale (NRS-11) and/or 20% by Oswestry Disability Index (ODI) with effect preservation for 12 months and more. Pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and lumbar lordosis (LL) were measured. PI-LL difference was calculated as well as PT/PI and SS/PI ratio, type of posture by P. Roussouly and leg length discrepancy were assessed.Results. Positive treatment results were achieved in 63 (79.75%) patients from the main group. The comparison of 2 groups showed that the main risk factor was the index of PT/PI ratio the odds ratio 6.39 (95% confidence interval (CI) 2.19-8.33; p=0.021) for the risk of SIJ dysfunction development and 4.1 (95% CI 1.98-5.86; p=0.031) for the negative treatment prognosis with that index threshold of 0.28 and 0.32, respectively.Conclusion. The detected reliable dependence between the retroversion degree and SIJ dysfunction development and treatment prognosis may become the basis for new additional studies