Toussaint R, Gawlik C S, Rehder U, Rüther W
Department of Orthopedics, University Hospital Eppendorf, Hamburg, Germany.
J Manipulative Physiol Ther. 1999 Mar-Apr;22(3):134-8. doi: 10.1016/S0161-4754(99)70125-9.
In the literature of manual medicine the sacroiliac joint is widely accepted as a potential source of low back pain. On the other hand, some investigations have detected sacroiliac joint dysfunction without concomitant low back pain. The prevalence of sacroiliac dysfunction in the population has been noted in the medical literature to be between 19.3% and 47.9%. However, the prevalence of sacroiliac dysfunction in the general population and for construction workers is unknown.
This article presents results from the Hamburg Construction Workers Study in respect to sacroiliac diagnostics. The prevalence of and connection between sacroiliac dysfunction and low back pain are particularly interesting.
The sacroiliac joint diagnostics were studied in a cross-section investigation of a cohort of 480 male construction workers. Manual examination is the standard in the diagnostics of sacroiliac joint conditions at present. The assessment of sacroiliac joint function by standing flexion test, the spine test, the iliac compression test, and the iliac springing test was operationalized as two categories: sacroiliac dysfunction I and II.
A prevalence of 29.0% was found for dysfunction I and 6.3% for dysfunction II, whereas a prevalence of 7.9% was found for the coprevalence of low back pain and sacroiliac dysfunction on the day of examination. This study demonstrated no statistical associations between low back pain and sacroiliac joint dysfunction.
The reason why symptomatic and asymptomatic sacroiliac dysfunctions exist has not yet been sufficiently explained. The identification of pain-provoking factors should be the aim of subsequent investigations. A further study with a prospective design will be necessary to answer the questions that remain.
在手法医学文献中，骶髂关节被广泛认为是腰背痛的一个潜在来源。另一方面，一些研究发现骶髂关节功能障碍但无伴随的腰背痛。医学文献中指出，人群中骶髂关节功能障碍的患病率在19.3%至47.9%之间。然而，普通人群和建筑工人中骶髂关节功能障碍的患病率尚不清楚。
本文介绍了汉堡建筑工人研究中关于骶髂关节诊断的结果。骶髂关节功能障碍与腰背痛之间的患病率及关联尤其令人关注。
对480名男性建筑工人队列进行横断面调查，研究骶髂关节诊断情况。目前，手法检查是骶髂关节疾病诊断的标准。通过站立前屈试验、脊柱试验、髂骨挤压试验和髂骨弹跳试验对骶髂关节功能进行评估，并分为两类：骶髂关节功能障碍I和II。
发现功能障碍I的患病率为29.0%，功能障碍II的患病率为6.3%，而在检查当天，腰背痛与骶髂关节功能障碍并存的患病率为7.9%。本研究表明腰背痛与骶髂关节功能障碍之间无统计学关联。
有症状和无症状的骶髂关节功能障碍存在的原因尚未得到充分解释。识别疼痛诱发因素应是后续研究的目标。有必要进行一项前瞻性设计的进一步研究来回答遗留的问题。
