Hammer Niels, Höch Andreas, Klima Stefan, Le Joncour Jean-Baptiste, Rouquette Corentin, Ramezani Maziar
Department of Anatomy, University of Otago, Dunedin, New Zealand.
Department of Orthopedic, Trauma and Plastic Surgery, University Clinics of Leipzig, Leipzig, Germany.
Clin Anat. 2019 Mar;32(2):231-237. doi: 10.1002/ca.23291. Epub 2018 Nov 21.
The sacrospinous (SS) and sacrotuberous (ST) ligaments form a complex at the posterior pelvis, with an assumed role as functional stabilizers. Experimental and clinical research has yielded controversial results regarding their function, both proving and disproving their role as pelvic stabilizers. These findings have implications for strategies for treating pelvic injury and pain syndromes. The aim of the present simulation study was to assess the influence of altered ligament function on pelvis motion. A finite elements computer model was used. The two-leg stance was simulated, with the load of body weight applied via the fifth lumbar vertebra and both femora, allowing for nutation of the sacroiliac joint. The in-silico kinematics were validated with in-vitro experiments using the same scenario of load application following SS and ST transection in six human cadavers. Modeling of partial or complete ligament failure caused significant increases in pelvis motion. This effect was most pronounced if the SS and ST were affected with 164% and 182%, followed by the sacroiliac and iliolumbar ligaments with 123% and 147%, and the pubic ligaments with 113% and 119%, for partial and complete disruption, respectively. Simultaneous ligament transection multiplied the effects on pelvis motion by up to 490%. Unilateral ligament injury altered the motion at the pelvis contralaterally. The experiments presented here provide strong evidence for the stabilizing role of the SS and ST. A fortiori, the instability resulting from partial or complete SS and ST injury merits consideration in treatment strategies involving these ligaments as important stabilizers. Clin. Anat. 32:231-237, 2019. © 2018 Wiley Periodicals, Inc.
骶棘韧带（SS）和骶结节韧带（ST）在骨盆后方形成一个复合体，被认为具有功能稳定作用。关于它们的功能，实验和临床研究得出了相互矛盾的结果，既有证据证明它们作为骨盆稳定器的作用，也有证据反驳这一作用。这些发现对骨盆损伤和疼痛综合征的治疗策略具有启示意义。本模拟研究的目的是评估韧带功能改变对骨盆运动的影响。使用了有限元计算机模型。模拟双腿站立姿势，通过第五腰椎和双侧股骨施加体重负荷，允许骶髂关节发生前屈。通过在六具人体尸体上进行SS和ST横断后采用相同负荷施加场景的体外实验，对计算机模拟运动学进行了验证。部分或完全韧带断裂的模型导致骨盆运动显著增加。如果SS和ST受到影响，这种影响最为明显，部分和完全断裂时分别增加164%和182%，其次是骶髂韧带和髂腰韧带，分别增加123%和147%，耻骨韧带分别增加113%和119%。同时切断韧带对骨盆运动的影响可增加至490%。单侧韧带损伤会改变对侧骨盆的运动。此处呈现的实验为SS和ST的稳定作用提供了有力证据。更有甚者，在涉及这些韧带作为重要稳定器的治疗策略中，应考虑到部分或完全SS和ST损伤导致的不稳定性。临床解剖学。32:231 - 237, 2019。© 2018威利期刊公司。
