Spine Surgery, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Spine (Phila Pa 1976). 2021 Jun 15;46(12):796-802. doi: 10.1097/BRS.0000000000003884.
A retrospective cross-sectional study.
This study aims to determine whether the sacroiliac (SI) joint motion correlated to pelvic incidence (PI) change from standing to supine position in patients with degenerative spinal diseases.
PI was found an unstable parameter after adolescence as the fixed nature of PI was challenged by several studies. The SI joint has been shown to have some motion, age-related degenerative changes of cartilage and SI ligaments contribute to SI joint instability.
The study contains both specimen study and radiographic study. One human specimen was acquired, on which PI was measured with different sacrum-ilium positions. In radiographic study, patients with old thoracolumbar fracture, lumbar disc herniation, stenosis, and spondylolisthesis were included. Ankylosing spondylitis (AS) patients were also included as control group. PI was measured on standing x-rays and scanogram of computed tomography images in supine position.
Specimen study result revealed that SI motion would lead to the change of PI with fixed pelvic thickness. In radiographic study, 101 patients with different etiology and 30 AS patients were included. After stratifying into different age groups, standing PI was significantly larger than supine PI in each age groups (P = 0.002, <0.001, and <0.001, respectively). In patients with degenerative diseases, PI was significantly larger on standing position than that on supine position. ΔPI showed no significant difference across etiologies. However, in AS patients, standing PI and supine PI revealed no significant difference (P = 0.528).
Mobile SI joint may be the cause of increased PI in the aging spine. The dynamic change of PI is etiology-independent if the SI joint was not fused. Older patients have greater position-related change of PI.Level of Evidence: 4.
回顾性横截面研究。
本研究旨在确定患有退行性脊柱疾病的患者，从站立位到仰卧位时骶髂（SI）关节运动与骨盆入射角（PI）变化是否相关。
PI 在青春期后被发现是一个不稳定的参数，因为有几项研究对 PI 的固定性质提出了挑战。已经表明 SI 关节具有一些运动，软骨和 SI 韧带的年龄相关退行性变化导致 SI 关节不稳定。
该研究包含标本研究和影像学研究。获得一个人体标本，在不同的骶骨-髂骨位置测量 PI。在影像学研究中，纳入陈旧性胸腰椎骨折、腰椎间盘突出症、狭窄和脊椎滑脱患者。还纳入强直性脊柱炎（AS）患者作为对照组。在站立位 X 线片和仰卧位 CT 扫描图像上测量 PI。
标本研究结果表明，SI 运动将导致骨盆厚度固定时 PI 的变化。在影像学研究中，纳入了 101 名不同病因的患者和 30 名 AS 患者。按不同年龄组分层后，各年龄组站立位 PI 均明显大于仰卧位 PI（P = 0.002、<0.001 和 <0.001）。在退行性疾病患者中，站立位 PI 明显大于仰卧位 PI。ΔPI 在不同病因之间无显著差异。然而，在 AS 患者中，站立位 PI 和仰卧位 PI 无显著差异（P = 0.528）。
活动的 SI 关节可能是老年脊柱中 PI 增加的原因。如果 SI 关节未融合，PI 的动态变化与病因无关。年龄较大的患者 PI 的体位相关变化更大。
4 级
