TY - JOUR
T1 - Biomechanical analysis of motion following sacroiliac joint fusion using lateral sacroiliac screws with or without lumbosacral instrumented fusion
AU - Dall, Bruce E.
AU - Eden, Sonia V.
AU - Cho, Woojin
AU - Karkenny, Alexa
AU - Brooks, Daina M.
AU - Hayward, Gerald M.
AU - Moldavsky, Mark
AU - Yandamuri, Soumya
AU - Bucklen, Brandon S.
N1 - Funding Information:
WC, AK, BED and SE have nothing to disclose. DMB, MM, SY, and BSB are paid employees of Globus Medical, Inc. The authors acknowledge funding for this project provided by the Musculoskeletal Education and Research Center (MERC), A Division of Globus Medical, Inc. MERC provided all equipment and testing apparatus such as the six-degrees-of-freedom spine motion simulator, and testing was performed by all authors in different phases of the study. MERC employees performed all aspects of data analysis and data collection. All authors reviewed and approved the final manuscript for submission.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/8
Y1 - 2019/8
N2 - Background: Sacroiliac joint hypermobility or aberrant mechanics may be a source of pain. The purpose of this study was to assess sacroiliac joint range of motion after simulated adjacent lumbosacral instrumented fusion, with or without sacroiliac joint fusion, with lateral sacroiliac screws. Methods: In this in vitro biomechanical study, seven cadaveric specimens were tested on a six-degrees-of-freedom machine under load control. Left posterior sacroiliac joint ligaments were severed to maximize joint range of motion. Influence of lumbosacral instrumentation on sacroiliac joint motion, with or without fixation, was studied. Findings: During flexion-extension in the setting of posterior sacroiliac joint injury and L5–S1 fixation, sacroiliac joint range of motion increased to 195% of intact. After fixation with lateral sacroiliac screws, average range of motion reduced to 144% of intact motion. Sacroiliac joint screws thus partially stabilized the joint and reduced motion. Use of 6 bilateral sacroiliac joint screws with L5–S1 screw and rod fixation in lateral bending and axial rotation yielded the greatest reduction in range of motion. Without lumbosacral fixation, baseline motion of the sacroiliac joint was reduced, and sacroiliac joint screw alone, using either 2, 3, or 6 screws, was able to restore motion at or below the level of an intact joint. Interpretation: Sacroiliac joint ligament injury with existing lumbosacral fixation doubled sacroiliac joint range of motion, but thereafter, fixation with lateral sacroiliac screws decreased range of motion of the injured sacroiliac joint. Screw configuration played a minor role, but generally, 6 sacroiliac joint screws had the greatest motion reduction.
AB - Background: Sacroiliac joint hypermobility or aberrant mechanics may be a source of pain. The purpose of this study was to assess sacroiliac joint range of motion after simulated adjacent lumbosacral instrumented fusion, with or without sacroiliac joint fusion, with lateral sacroiliac screws. Methods: In this in vitro biomechanical study, seven cadaveric specimens were tested on a six-degrees-of-freedom machine under load control. Left posterior sacroiliac joint ligaments were severed to maximize joint range of motion. Influence of lumbosacral instrumentation on sacroiliac joint motion, with or without fixation, was studied. Findings: During flexion-extension in the setting of posterior sacroiliac joint injury and L5–S1 fixation, sacroiliac joint range of motion increased to 195% of intact. After fixation with lateral sacroiliac screws, average range of motion reduced to 144% of intact motion. Sacroiliac joint screws thus partially stabilized the joint and reduced motion. Use of 6 bilateral sacroiliac joint screws with L5–S1 screw and rod fixation in lateral bending and axial rotation yielded the greatest reduction in range of motion. Without lumbosacral fixation, baseline motion of the sacroiliac joint was reduced, and sacroiliac joint screw alone, using either 2, 3, or 6 screws, was able to restore motion at or below the level of an intact joint. Interpretation: Sacroiliac joint ligament injury with existing lumbosacral fixation doubled sacroiliac joint range of motion, but thereafter, fixation with lateral sacroiliac screws decreased range of motion of the injured sacroiliac joint. Screw configuration played a minor role, but generally, 6 sacroiliac joint screws had the greatest motion reduction.
KW - Lateral sacroiliac screws
KW - Lumbosacral instrumented fusion
KW - Range of motion
KW - Sacroiliac joint
KW - Sacroiliac joint fusion
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U2 - 10.1016/j.clinbiomech.2019.05.025
DO - 10.1016/j.clinbiomech.2019.05.025
M3 - Article
C2 - 31234032
AN - SCOPUS:85067563583
SN - 0268-0033
VL - 68
SP - 182
EP - 189
JO - Clinical Biomechanics
JF - Clinical Biomechanics
ER -