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骶髂关节相关疼痛与脊柱骨盆活动度的关系。

Relationship Between Sacroiliac Joint-related Pain and Spinopelvic Mobility.

机构信息

Department of Orthopedic Surgery, Kanto Rosai Hospital, Kawasaki City, Kanagawa Prefecture, Japan.

Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Spine (Phila Pa 1976). 2022 Sep 15;47(18):E582-E586. doi: 10.1097/BRS.0000000000004390. Epub 2022 Jun 29.

Abstract

STUDY DESIGN

A case-control study.

OBJECTIVE

To evaluate the relationship between sacroiliac joint-related pain (SIJ-RP) and spinopelvic mobility.

SUMMARY OF BACKGROUND DATA

No specific radiological findings are available for the diagnosis of SIJ-RP. A previous study reported that a higher pelvic incidence and sacral slope (SS) values were significantly associated with sacroiliac joint pain. The concept of spinopelvic mobility, which is evaluated by the differences between SS in the standing and sitting positions, has been the focus of hip and spine surgeries in recent years.

MATERIALS AND METHODS

The SIJ-RP group comprised patients diagnosed with SIJ-RP based on physical findings and their response to analgesic injections. No other lumbar or hip joint diseases were observed. The non-SIJ-RP group comprised patients with lower back pain for reasons other than SIJ-RP. Radiographs of the lateral view of the pelvis in the standing and sitting positions were evaluated for all patients. We compared and analyzed the backgrounds, SS in the two positions, and difference in SS between the two positions in both groups.

RESULTS

In total, 245 patients were included in the study, with 49 and 196 patients in the SIJ-RP and non-SIJ-RP groups, respectively. More female patients experienced SIJ-RP than male patients ( P =0.0361). There were significant differences between the groups for SS in standing ( P =0.0076), sitting ( P =0.0005), and those with a difference between sitting and standing of <5° ( P =0.0278) in the univariate analyses. Logistic regression analyses, after adjustment for age and sex, revealed significant differences between the groups with an SS difference <5° ( P =0.0088; 95% confidence interval, 1.280-5.519), with an odds ratio of 2.7.

CONCLUSION

On evaluating spinopelvic mobility, we found that SIJ-RP was related to hypomobility of the sacrum, which could indicate the hypermobility of the sacroiliac joint.

摘要

研究设计

病例对照研究。

目的

评估骶髂关节相关疼痛(SIJ-RP)与脊柱骨盆活动性之间的关系。

背景资料概要

目前尚无针对 SIJ-RP 诊断的特定影像学发现。先前的一项研究报告称,较高的骨盆入射角和骶骨斜率(SS)值与骶髂关节疼痛显著相关。近年来,脊柱骨盆活动性的概念一直是髋关节和脊柱手术的焦点,该概念通过站立位和坐位 SS 之间的差异来评估。

材料和方法

SIJ-RP 组包括根据体格检查和镇痛注射反应诊断为 SIJ-RP 的患者。未观察到其他腰椎或髋关节疾病。非 SIJ-RP 组包括因非 SIJ-RP 引起的下腰痛患者。所有患者均进行站立位和坐位骨盆侧位 X 线片评估。我们比较和分析了两组患者的背景、两个位置的 SS 以及两个位置 SS 的差异。

结果

共纳入 245 例患者,其中 SIJ-RP 组 49 例,非 SIJ-RP 组 196 例。女性患者中 SIJ-RP 的发生率高于男性(P=0.0361)。单因素分析显示,两组在站立位 SS(P=0.0076)、坐位 SS(P=0.0005)以及坐位与站立位 SS 差值<5°(P=0.0278)方面存在显著差异。在调整年龄和性别后,多变量 logistic 回归分析显示,SS 差值<5°的两组之间存在显著差异(P=0.0088;95%置信区间,1.280-5.519),优势比为 2.7。

结论

在评估脊柱骨盆活动性时,我们发现 SIJ-RP 与骶骨活动度降低有关,这可能表明骶髂关节活动过度。

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