Sichting Freddy, Rossol Jerome, Soisson Odette, Klima Stefan, Milani Thomas, Hammer Niels
Technische Universitat Chemnitz, Germany; University of Leipzig, Germany.
Pain Physician. 2014 Jan-Feb;17(1):43-51.
The sacroiliac joint is a widely described source of low back pain. Therapeutic approaches to relieve pain include the application of pelvic belts. However, the effects of pelvic belts on sacroiliac joint ligaments as potential pain generators are mostly unknown.
The aim of our study was to analyze the influence of pelvic belts on ligament load by means of a computer model.
Experimental computer study using a finite element method.
A computer model of the human pelvis was created, comprising bones, ligaments, and cartilage. Detailed geometries, material properties of ligaments, and in-vivo pressure distribution patterns of a pelvic belt were implemented. The effects of pelvic belts on ligament strain were computed in the double-leg stance.
Pelvic belts increase sacroiliac joint motion around the sagittal axis but decrease motion around the transverse axis. With pelvic belt application, most of the strained sacroiliac joint ligaments were relieved, especially the sacrospinous, sacrotuberous, and the interosseous sacroiliac ligaments. Sacroiliac joint motion and ligament strains were minute. These results agree with validation data from other studies.
Assigning homogenous and linear material properties and excluding muscle forces are clear simplifications of the complex reality.
Pelvic belts alter sacroiliac joint motion and provide partial relief of ligament strain that is subjectively marked, although minimal in absolute terms. These findings confirm theories that besides being mechanical stabilizers, the sacroiliac joint ligaments are likely involved in neuromuscular feedback mechanisms. The results from our computer model help with unraveling the therapeutic mechanisms of pelvic belts.
骶髂关节是导致下腰痛的一个被广泛提及的原因。缓解疼痛的治疗方法包括使用骨盆带。然而，骨盆带对作为潜在疼痛源的骶髂关节韧带的影响大多未知。
我们研究的目的是通过计算机模型分析骨盆带对韧带负荷的影响。
使用有限元方法的实验性计算机研究。
创建了一个人体骨盆的计算机模型，包括骨骼、韧带和软骨。实施了详细的几何形状、韧带的材料特性以及骨盆带的体内压力分布模式。在双腿站立姿势下计算骨盆带对韧带应变的影响。
骨盆带增加了骶髂关节在矢状轴周围的运动，但减少了在横轴周围的运动。使用骨盆带时，大多数紧张的骶髂关节韧带得到缓解，尤其是骶棘韧带、骶结节韧带和骶髂骨间韧带。骶髂关节运动和韧带应变很小。这些结果与其他研究的验证数据一致。
赋予均匀和线性材料特性以及排除肌肉力量显然是对复杂现实的简化。
骨盆带改变骶髂关节运动，并部分缓解主观上明显的韧带应变，尽管绝对值很小。这些发现证实了这样的理论，即除了作为机械稳定器外，骶髂关节韧带可能参与神经肌肉反馈机制。我们计算机模型的结果有助于揭示骨盆带的治疗机制。
