Pelvic orthosis effects on posterior pelvis kinematics An in-vitro biomechanical study

Abstract

The sacroiliac joint (SIJ) is a well-known source of low back pain, with increasing interest for both conservative and surgical treatment. Alterations in pelvis kinematics are hypothesized as a contributor to SIJ pain and pelvic orthoses one treatment option, but their effects on the pelvis are poorly understood. Alterations in movement patterns induced by the application of pelvic orthoses were determined in five human cadaveric pelvises. Deformations were obtained from the lumbosacral transition and the bilateral SIJ, using digital image correlation and a customized routine to compute the movements within the pelvis. Significant alterations were found for the movements at the SIJ, in particular a vast increase in axial (x-axis) rotation, accompanied by increased inferior (y-) translation of the sacrum relative to the ilium. Movement patterns at the lumbosacral transition changed, causing increases in axial rotation and decreased inferior translation of L5 relative to S1. Using a physiologic mode of load application gives novel insights into the potential effects of pelvic orthoses. The results of these in-vitro experiments vary markedly from previous experiments with loading limited to two or less axes. Furthermore, the influence of pelvic orthoses on the lumbosacral transition warrants further investigation.

In Silico Pelvis and Sacroiliac Joint Motion: Refining a Model of the Human Osteoligamentous Pelvis for Assessing Physiological Load Deformation Using an Inverted Validation Approach

“…Regression analysis: R 2 was 0.69, 0.99, and 0.56, for the 2 mm shell, 3 mm shell, and the solid bone model, respectively. More detail on the load deformations in the cadaveric pelvises can be found in Klima et al and Hammer et al [40, 41].…”

“…Also, the coordinate system used here was different from the coordinate system recommendations of the ISB. Though this forms a shortcoming of the given study, the choice of coordinate system was done in line with previous research, our own work [40, 41], and the coordinate system used clinically by SIJ surgeons, orthopedics, and pain therapists.…”

“…For further comparison, the 500-N load step was used from the male pelvises, in line with the in silico experiments shown here. Further information on this novel physiologic loading scenario can be found in Hammer et al and Klima et al [40, 41]. Data were retrieved for the deformation of the entire pelvis and the SIJ bilaterally, as outlined by the markerpoints shown in Figure 1.…”

An Indication-Based Concept for Stepwise Spinal Orthosis in Low Back Pain According to the Current Literature

“…The orthosis must be clearly defined in terms and function (Table 1). Only when a differentiated cause of the complaint according to "specific diagnosis" was determined (group A) and the appropriately adapted "diagnosis based orthosis" was used (group C), were positive effects found in prospective studies ( [2,5,9,22,28,30], Table 1), one retrospective study ( [28], Table 1) and one review article ([10], Table 2).…”

Can Thoracolumbar Deformity Improve if Surgery Just for Lumbar Stenois Syndrome in Degenerative Thoracolumbar Kyphosis Patients ?

“…Once S1 was chosen as lower instrumented vertebrae (LIV), the sacral slope (SS) and pelvic tilt (PT) was hardly to be changed since the pelvic incidence (PI) was almost xed in the adult where PI=PT+SS. So, the parameters may be signi cant when L5 was as LIV with more range of pevic rotation [ (12,13)]. While it is unclear whether TLK can be in uenced when L5 or S1 is chosen as LIV in short-segment fusion through biomechanical chain.…”