Department of Orthopeadic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, Japan.
Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan.
Eur Spine J. 2021 May;30(5):1314-1319. doi: 10.1007/s00586-020-06700-4. Epub 2021 Jan 3.
Recently, the number of adult spinal deformity surgeries including sacroiliac joint fixation (SIJF) by using an S2 alar iliac screw or iliac screw has increased to avoid the distal junctional failure. However, we occasionally experienced patients who suffered from hip pain after a long instrumented spinal fusion. We hypothesized that long spinal fusion surgery including SIJF influenced the hip joint as an adjacent joint. The aim of this paper was to evaluate the association between spinal deformity surgery including SIJF and radiographic progression of hip osteoarthritis (OA).
This study was retrospective cohort study. In total, 118 patients who underwent spinal fusion surgery at single center from January 2013 to August 2018 were included. We measured joint space width (JSW) at central space of the hip joint. We defined reduction of more than 0.5 mm/year in JSW as hip OA progression. The patients were divided into two groups depending on either a progression of hip osteoarthritis (Group P), or no progression (Group N).
The number of patients in Group P and Group N was 47 and 71, respectively. Factor that was statistically significant for hip OA was SIJF (p = 0.0065, odds ratio = 7.1, 95% confidence interval = 1.6-31.6). There were no other significant differences by the multiple logistic regression analysis.
This study identified spinal fixation surgery that includes SIJF as a predictor for radiographic progression of hip OA over 12 months. We should pay attention to hip joint lesions after adult spinal deformity surgery, including SIJF.
最近，包括使用骶髂关节固定（SIJF）在内的成人脊柱畸形手术数量（通过 S2 髂骨螺钉或髂骨螺钉）有所增加，以避免远端交界性失败。然而，我们偶尔会遇到一些患者在长节段脊柱融合后出现髋部疼痛。我们假设包括 SIJF 的长节段脊柱融合手术会影响髋关节作为相邻关节。本文旨在评估包括 SIJF 的脊柱畸形手术与髋关节骨关节炎（OA）放射学进展之间的关系。
这是一项回顾性队列研究。共有 118 名患者于 2013 年 1 月至 2018 年 8 月在单中心接受脊柱融合手术，纳入本研究。我们测量髋关节中央间隙的关节间隙宽度（JSW）。我们将 JSW 每年减少超过 0.5 毫米定义为髋关节 OA 进展。根据是否存在髋关节 OA 进展（进展组，Group P）或无进展（无进展组，Group N）将患者分为两组。
进展组和无进展组的患者数分别为 47 例和 71 例。对髋关节 OA 有统计学意义的因素是 SIJF（p=0.0065，比值比=7.1，95%置信区间=1.6-31.6）。多因素逻辑回归分析无其他显著差异。
本研究确定包括 SIJF 的脊柱固定手术是 12 个月内髋关节 OA 放射学进展的预测因素。我们应该注意包括 SIJF 的成人脊柱畸形手术后髋关节病变。
