Relation Between Form and Function in the Sacroiliac Joint

Vleeming, Adriaan; Volkers, A.; Snijders, Christian J.; Stoeckart, Rob

doi:10.1097/00007632-199002000-00017

Cited by 189 publications

(79 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although conservative management (CM) remains the first-line treatment for SIJ pain, a significant number of patients do not respond well, resulting in unremitting pain. The innervation, movement and elucidation of basic biomechanics [10][11][12] of the SIJ justify its treatment with sacroiliac joint fusion (SIJF). Approaches to SIJF were reported as early as the 1920s [13,14] and case series of open SIJF report modest to good effectiveness [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

et al. 2016

View full text Add to dashboard Cite

Purpose To compare the safety and effectiveness of minimally invasive sacroiliac joint fusion (SIJF) using triangular titanium implants vs conservative management (CM) in patients with chronic sacroiliac joint (SIJ) pain. Methods 103 adults with chronic SIJ pain at nine sites in four European countries were randomly assigned to and underwent either minimally invasive SIJF using triangular titanium implants (N = 52) or CM (N = 51). CM was performed according to the European guidelines for the diagnosis and management of pelvic girdle pain and consisted of optimization of medical therapy, individualized physical therapy (PT) and adequate information and reassurance as part of a multifactorial treatment. The primary outcome was the difference in change in self-rated low back pain (LBP) at 6 months. Additional endpoints included quality of life using EQ-5D-3L, disability using Oswestry Disability Index (ODI), SIJ function using active straight leg raise (ASLR) test and adverse events. NCT01741025. Results At 6 months, mean LBP improved by 43.3 points in the SIJF group and 5.7 points in the CM group (difference of 38.1 points, p \ 0.0001). Mean ODI improved by 26 points in the SIJF group and 6 points in the CM group (p \ 0.0001). ASLR, EQ-5D-3L, walking distance and satisfaction were statistically superior in the SIJF group. The frequency of adverse events did not differ between groups. One case of postoperative nerve impingement occurred in the surgical group. Conclusions In patients with chronic SIJ pain, minimally invasive SIJF using triangular titanium implants was safe and more effective than CM in relieving pain, reducing disability, improving patient function and quality of life.

show abstract

Section: Introductionmentioning

confidence: 99%

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The combination of matching articular surfaces and the stabilising influence of the ligaments provide what has been termed form closure of the joint (Fig. 3a) [36,37]. Additionally, the combined action of a number of abdominal and pelvic muscles provides what has been termed force closure of the joint by a compressive mechanism on the pelvic ring (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the combined action of a number of abdominal and pelvic muscles provides what has been termed force closure of the joint by a compressive mechanism on the pelvic ring (Fig. 4a) [36,37]. Traumatic disruption of the posterior ligamentous complex or laxity induced by the hormonal changes of the peri-partum period may lead to a failure of form closure of the joint [36,37].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Metabolic disturbances identified by SPECT-CT in patients with a clinical diagnosis of sacroiliac joint incompetence

et al. 2013

View full text Add to dashboard Cite

Purpose To establish the sensitivity and specificity of cross-sectional scintigraphy [single photon emission computed tomography (SPECT)] combined with computed X-ray tomography (CT) in the detection of sacroiliac joint (SIJ) mechanical dysfunction and evaluate reproducibility of reporting. Methods Patients with pelvic girdle pain either on the basis of peri-partum SIJ dysfunction or trauma were included. These patients were imaged with bone scintigraphy with hybrid imaging with SPECT/CT. Results The study group comprised 100 patients (72 females, 28 males). Trauma accounted for 52 % and the remainder were patients with peri-partum pain. Average age was 43 years and average length of history was [2 years. The major finding was increased uptake in the upper SIJ and posterior soft-tissues/ligaments. Hybrid imaging had a sensitivity of 95 % and specificity of 99 %. Positive predictive value was 99 % and negative predictive value 94 %. Power of the test was 1.0. Reproducibility of the test was good with kappa values of 0.85. ConclusionHybrid imaging with SPECT/CT reproducibly demonstrates metabolic alterations around the SIJ in patients with SIJ dysfunction, which we have termed SIJ incompetence. The condition is more common than previously recognised and frequently occurs after trauma, which has not been reported previously.

show abstract

“…30 The sacroiliac joint (SIJ) has been extensively studied relative to its ligament support and muscle-stabilizing system. [31][32][33] The SIJ contribution to postpartum LBP and nonradicular LBP has been described with biomechanical and injection response methods. [34][35][36][37] Asymmetric (left vs right) SIJ compliance, measured by Doppler imaging of vibration (DIV), has been correlated with peripartum LBP.…”

mentioning

confidence: 99%

Gynecological Surgery and Low Back Pain in Older Women

Ericksen

Pidcoe

Ketchum

et al. 2010

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

Objective: To determine sacroiliac joint compliance characteristics and pelvic floor movements in older women relative to gynecological surgery history and back pain complaints. Design: Single-visit laboratory measurement. Setting: University clinical research center. Participants: Twenty-five women aged 65 years or older. Outcome Measures: Sacroiliac joint compliance measured by Doppler imaging of vibrations and ultrasound measures of pelvic floor motion during the active straight leg raise test. Results: Doppler imaging of vibrations demonstrated test reliability ranging from 0.701 to 0.898 for detecting vibration on the ilium and sacrum sides of the sacroiliac joint. The presence of low-back pain or prior gynecological surgery was not significantly associated with a difference in the compliance or laxity symmetry of the sacroiliac joints. No significant difference in pelvic floor movement was found during the active straight leg raise test between subject groups. All P values were .4159. Conclusions: Prior gynecological surgery and low-back pain were not significantly associated with side-to-side differences in the compliance of the sacroiliac joints or in significant changes in pelvic floor movement during a loading maneuver in a group of older women.Keywords aging, back pain, gynecologic surgery, sacroiliac joint, pelvic floor, Doppler imaging of vibrations Extensive low-back pain (LBP) research has modeled lumbopelvic stability derived from both global (multisegmental) muscles and more local or single-segment muscles. 1 A control system model integrated the active anatomic elements, passive anatomic elements, and the arthrokinetic control elements (sensory afferents; spinal, subcortical, and cortical neurons; efferent motor elements). 2,3 These models fostered extensive investigation into neuromuscular control and stability of the lumbopelvic junction with early observations of altered motor control in specific muscles in LBP populations 4-7 with rapid carryover into rehabilitation efforts focused on neuromuscular reeducation of the deep abdominal and pelvic floor muscles, part of the so-called core stability system, in LBP populations. 8,9 The abdominal wall muscles are postulated to contribute to lumbopelvic stability in part due to linkage with the thoracolumbar fascia system. 10 Deep abdominal muscles were observed to have altered activation patterns in chronic LBP populations during specific load challenges compared with normal populations. 5,6,11,12 Further work described similar premovement activation implicated as postural contributions to spine stability, in the pelvic floor muscles, deep fibers of the multifidus muscle, and the respiratory diaphragm. [13][14][15][16][17][18][19][20][21][22] Altered neurophysiological control of pelvis and abdominal muscles using electromyographic, ultrasound, athletic performance, and postural measures has been linked to LBP conditions. 11,[23][24][25][26][27] These observations of changes in muscle neurophysiological control in LBP populations, combined ...

show abstract

Relation Between Form and Function in the Sacroiliac Joint

Cited by 189 publications

References 0 publications

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

Metabolic disturbances identified by SPECT-CT in patients with a clinical diagnosis of sacroiliac joint incompetence

Gynecological Surgery and Low Back Pain in Older Women

Contact Info

Product

Resources

About