Sex Specific Sacroiliac Joint Biomechanics During Standing Upright

Joukar, Amin; Shah, Anoli; Kiapour, Ali; Vosoughi, Ardalan Seyed; Duhon, Bradley; Agarwal, Anand; Elgafy, Hossein; Ebraheim, Nabil A.; Goel, Vijay K.

doi:10.1097/brs.0000000000002623

Cited by 61 publications

(63 citation statements)

References 22 publications

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“…SIJ pain is a common disease that affects 90% of adults throughout their lives [ 2 ]. Manipulations have a good effect on SIJ pain with no specific cause.…”

Section: Discussionmentioning

confidence: 99%

A finite element analysis of sacroiliac joint displacements and ligament strains in response to three manipulations

Zhang

Liao

et al. 2020

BMC Musculoskelet Disord

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Background Clinical studies have found that manipulations have a good clinical effect on sacroiliac joint (SIJ) pain without specific causes. However, the specific mechanisms underlying the effect of manipulations are still unclear. The purpose of this study was to investigate the effects of three common manipulations on the stresses and displacements of the normal SIJ and the strains of the surrounding ligaments. Methods A three-dimensional finite element model of the pelvis-femur was developed. The manipulations of hip and knee flexion (MHKF), oblique pulling (MOP), and lower limb hyperextension (MLLH) were simulated. The stresses and displacements of the SIJ and the strains of the surrounding ligaments were analyzed during the three manipulations. Results MOP produced the highest stress on the left SIJ, at 6.6 MPa, while MHKF produced the lowest stress on the right SIJ, at 1.5 MPa. The displacements of the SIJ were all less than 1 mm during the three manipulations. The three manipulations caused different degrees of ligament strain around the SIJ, and MOP produced the greatest straining of the ligaments. Conclusion The three manipulations all produced small displacements of the SIJ and different degrees of ligament strains, which might be the mechanism through which they relieve SIJ pain. MOP produced the largest displacement and the greatest ligament strains.

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“…SIJ pain is a common disease that affects 90% of adults throughout their lives [ 2 ]. Manipulations have a good effect on SIJ pain with no specific cause.…”

Section: Discussionmentioning

confidence: 99%

A finite element analysis of sacroiliac joint displacements and ligament strains in response to three manipulations

Zhang

Liao

et al. 2020

BMC Musculoskelet Disord

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“…Posterior ligaments (5) Posterior superior iliac spine to sacral tubercles Sacral extension Long ligament Short ligament Sacrotuberous (4) Posterior superior iliac spine and sacrum to ischial tuberosity Sacral flexion Sacrospinous (3) Apex of the sacrum to ischial spine Sacral flexion Anterior ligament (6) Crosses ventral and caudal aspect of SIJ Sacral flexion, axial rotation Interosseous (8) Between sacrum and ilium dorsal to SIJ Sacral flexion, axial rotation Iliolumbar (…”

Section: Location Primary Restraintmentioning

confidence: 99%

“…4 These sex differences also reflect in the biomechanics of the joint: the female SIJ has higher mobility, and more stresses, loads, and pelvisligament strains, compared to the male SIJ. 5 Recent studies have reported a higher prevalence of LBP due to the SIJ, with some reports having estimated that the SIJ is the actual source of pain in 15% to 30% of cases. [6][7][8] From an anatomical perspective, pathologic changes and injuries specific to different SIJ structures can result in SIJ pain.…”

Section: Introductionmentioning

confidence: 99%

Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain

et al. 2019

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Background: The sacroiliac joints (SIJs), the largest axial joints in the body, sit in between the sacrum and pelvic bones on either side. They connect the spine to the pelvis and thus facilitate load transfer from the lumbar spine to the lower extremities. The majority of low back pain (LBP) is perceived to originate from the lumbar spine; however, another likely source of LBP that is mostly overlooked is the SIJ. This study (Parts I and II) aims to evaluate the clinical and biomechanical literature to understand the anatomy, biomechanics, sexual dimorphism, and causes and mechanics of pain of the SIJ leading to conservative and surgical treatment options using instrumentation. Part II concludes with the mechanics of the devices used in minimal surgical procedures for the SIJ. Methods: A thorough review of the literature was performed to analyze studies related to normal SIJ mechanics, as well as the effects of sex and pain on SIJ mechanics. Results: A total of 65 studies were selected related to anatomy, biomechanical function of the SIJ, and structures that surround the joints. These studies discussed the effects of various parameters, gender, and existence of common physiological disorders on the biomechanics of the SIJ. Conclusions: The SIJ lies between the sacrum and the ilium and connects the spine to the pelvic bones. The SIJ transfers large bending moments and compression loads to lower extremities. However, the joint does not have as much stability of its own against the shear loads but resists shear due the tight wedging of the sacrum between hip bones on either side and the band of ligaments spanning the sacrum and the hip bones. Due to these, sacrum does not exhibit much motion with respect to the ilium. The SIJ range of motion in flexion-extension is about 38, followed by axial rotation (about 1.58), and lateral bending (about 0.88). The sacrum of the female pelvis is wider, more uneven, less curved, and more backward tilted, compared to the male sacrum. Moreover, women exhibit higher mobility, stresses/loads, and pelvis ligament strains compared to male SIJs. Sacroiliac pain can be due to, but not limited to, hypo-or hypermobility, extraneous compression or shearing forces, micro-or macro-fractures, soft tissue injury, inflammation, pregnancy, adjacent segment disease, leg length discrepancy, and prior lumbar fusion. These effects are well discussed in this review. This review leads to Part II, in which the literature on mechanics of the treatment options is reviewed and synthesized.

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“…Several authors have investigated the biomechanics of the SIJ after spinal or SIJ fusion using a computational approach. [45][46][47] Mao et al 48 investigated the effect of lumbar lordosis alteration on sacrum angular displacement after lumbosacral fusion using finite element analysis. Decreasing and increasing lumbar lordosis resulted in increased sacrum angular motion.…”

Section: In Silico Studiesmentioning

confidence: 99%

Biomechanics of the Sacroiliac Joint: Surgical Treatments

et al. 2020

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Background: Fixation is one of the most common surgical techniques for the treatment of chronic pain originating from the sacroiliac joint (SIJ). Many studies have investigated the clinical outcomes and biomechanics of various SIJ surgical procedures. However, the biomechanical literature points to several issues that need to be further explored, especially for the devices used in minimally invasive surgery of the SIJ. This study (part II) aims to assess biomechanical literature to understand the existing information as it relates to efficacies of the surgical techniques and the gaps in the knowledge base. Part I reviewed basic anatomy and mechanics of the SIJ joint, including difference between males and females, and causes of pain emanating from these joints. Methods: A thorough literature review was performed pertaining to studies related to SIJ fixation techniques and the biomechanical outcomes of the surgical procedures. Results: Fifty-five studies matched the search criteria and were considered for the review. These articles predominantly pertained to the biomechanical outcomes of the minimally invasive surgery with different instrumentation systems and surgical settings. Conclusions: The SIJ is one of the most overlooked sources of lower back pain. The joint is responsible for the pain in 15% to 30% of people suffering from lower back pain. Various studies have investigated the clinical outcomes of different surgical procedures intended to improve the pain and quality of life following surgery. The data show that these techniques are indeed effective. However, clinical studies have raised several issues, like optimal number and positioning of implants, unilateral versus bilateral placements, adjacent segment disease, implant designs, and optimal location of implants with respect to variations in bone density across the SIJ. Biomechanical studies using in vitro and in silico techniques have addressed some of these issues. Studies also point out the need for additional investigations for a better understanding of the underlying mechanics for the improved long-term surgical outcomes. Further long-term clinical follow-ups are essential as well. This review presents pertinent findings.

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Sex Specific Sacroiliac Joint Biomechanics During Standing Upright

Abstract: N/A.

Cited by 61 publications

References 22 publications

A finite element analysis of sacroiliac joint displacements and ligament strains in response to three manipulations

A finite element analysis of sacroiliac joint displacements and ligament strains in response to three manipulations

Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain

Biomechanics of the Sacroiliac Joint: Surgical Treatments

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