Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, Nara Medical University, Nara, Japan.
Medicine (Baltimore). 2023 Aug 25;102(34):e34487. doi: 10.1097/MD.0000000000034487.
The sacroiliac joint (SIJ) is the largest axial joint in the human body, and the SIJ vacuum phenomenon (SIJ VP) is a common finding in computed tomography studies of the abdomen, pelvis, and lumbosacral spine in adults, with the incidence increasing with age. Adolescent idiopathic scoliosis (AIS) is an abnormal spinal curvature that appears during adolescence and places abnormal stress on the SIJs. This retrospective observational study aimed to investigate the incidence of the SIJ VP in thoracic AIS (Lenke types 1 and 2). Sixty-seven patients with AIS (age: 12-19 years) and 76 controls (age: 11-19 years) were retrospectively analyzed to investigate SIJ VP, subchondral bone cysts, and SIJ degeneration (Eno classification: type 0, no degenerative change; type 1, mild degenerative changes; type 2, substantial degenerative changes; and type 3, ankylosis). SIJ degeneration was defined as type ≥ 2. The association between SIJ VP, cysts, SIJ degeneration, and sagittal/coronal spinopelvic alignment was assessed. SIJ VP (59% vs. 35.5%, P < .01), cysts (32.8% vs. 1.3%, P < .01), and SIJ degeneration (3.2% vs. 2.6%, P = .823) differed significantly between the 2 groups. There were 0 cases of SIJ ankylosis (Eno classification type 3) in both groups. The VP was not correlated with lumbar lordosis, sacral slope, or Cobb angle. All lumbar modifier type C belonged to the VP present group, whereas none to VP absent group. Our results suggest an association between AIS and SIJ VP and SIJ cysts. SIJ VP and SIJ cysts in AIS may be caused and accelerated by abnormal mechanical stress on SIJ due to spinal deformity.
骶髂关节 (SIJ) 是人体最大的轴向关节，SIJ 真空现象 (SIJ VP) 是成年人腹部、骨盆和腰骶脊柱计算机断层扫描研究中的常见发现，其发生率随着年龄的增长而增加。青少年特发性脊柱侧凸 (AIS) 是一种在青春期出现的异常脊柱弯曲，它会对 SIJ 施加异常的压力。本回顾性观察性研究旨在探讨胸段 AIS（Lenke 型 1 和 2）中 SIJ VP 的发生率。回顾性分析了 67 例 AIS 患者（年龄：12-19 岁）和 76 例对照组（年龄：11-19 岁），以调查 SIJ VP、软骨下骨囊肿和 SIJ 退变（Eno 分类：0 型，无退行性改变；1 型，轻度退行性改变；2 型，明显退行性改变；3 型，强直）。SIJ 退变定义为≥2 型。评估了 SIJ VP、囊肿、SIJ 退变与矢状/冠状脊柱骨盆对线的关系。两组间 SIJ VP（59%比 35.5%，P<.01）、囊肿（32.8%比 1.3%，P<.01）和 SIJ 退变（3.2%比 2.6%，P=.823）差异有统计学意义。两组均无 SIJ 强直（Eno 分类 3 型）。VP 与腰椎前凸、骶骨倾斜或 Cobb 角无关。所有腰椎修正 C 型均属于 VP 存在组，而 VP 不存在组则没有。我们的结果表明 AIS 与 SIJ VP 和 SIJ 囊肿之间存在关联。AIS 中的 SIJ VP 和 SIJ 囊肿可能是由于脊柱畸形导致 SIJ 异常机械应力而引起和加速的。
