Luoyang Orthopedic Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, Henan Province, China.
Hunan University of Chinese Medicine, Changsha, Hunan Province, China.
PeerJ. 2024 Sep 26;12:e18083. doi: 10.7717/peerj.18083. eCollection 2024.
A systematic review and meta-analysis for incidence and risk factors of new-onset sacroiliac joint pain (SIJP) after spinal surgery aimed to provide evidence-based medical references for its early prevention, timely intervention, and appropriate treatment.
The protocol of the systematic review and meta-analysis was registered in the International Prospective Register of Systematic Review (PROSPERO) with the PROSPERO ID (CRD42023463177). Relevant studies were searched to January 2024 from the databases of PubMed, Embase, Cochrane Library, and Web of Science, and the types of studies were cohort studies, case-control studies, and cross-sectional studies. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) and the Cross-Sectional/Prevalence Study Quality recommended by the Agency for Healthcare Research and Quality (AHRQ). Two authors conducted studies search, data extraction, and quality assessment independently. Meta-analyses were done using Stata 14.0 software.
Twelve observational studies with 3,570 spinal surgery patients were included. Ten were case-control studies, one was a cross-sectional study, and another was a cohort study, all of which were of moderate quality and above. The results of the meta-analysis showed that the incidence of new-onset SIJP after spinal surgery was 9.40%; females, no. of surgical segments, fusion to the sacrum, and postoperative pelvic tilt (PT) were significantly associated with the new-onset SIJP after spinal surgery. Meta-analyses for preoperative and postoperative controls of spondylopelvic parameters showed that postoperative lumbar lordosis (LL) in the SIJP group and postoperative LL and sacral slope (SS) of patients in the NoSIJP group had significant differences from preoperative.
Available evidence suggests that an increased risk of new-onset SIJP after spinal surgery is associated with sex, multi-segmental surgery, fusion to the sacrum, and greater postoperative PT.
对脊柱手术后新发骶髂关节痛（SIJP）的发生率及危险因素进行系统评价和 meta 分析，旨在为其早期预防、及时干预和恰当治疗提供循证医学参考。
本系统评价和 meta 分析的方案已在国际前瞻性系统评价注册库（PROSPERO）中注册，注册号为 PROSPERO ID（CRD42023463177）。从 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库中检索到 2024 年 1 月之前的相关研究，研究类型为队列研究、病例对照研究和横断面研究。使用纽卡斯尔-渥太华量表（NOS）和医疗保健研究与质量局（AHRQ）推荐的横断面/患病率研究质量标准对研究质量进行评估。两名作者独立进行研究检索、数据提取和质量评估。使用 Stata 14.0 软件进行 meta 分析。
纳入了 12 项观察性研究，共 3570 例脊柱手术患者。其中 10 项为病例对照研究，1 项为横断面研究，另 1 项为队列研究，所有研究均为中高质量以上。meta 分析结果显示，脊柱手术后新发 SIJP 的发生率为 9.40%；女性、手术节段数、融合至骶骨和术后骨盆倾斜（PT）与脊柱手术后新发 SIJP 显著相关。对脊柱矢状参数术前和术后的控制进行 meta 分析，结果显示 SIJP 组术后腰椎前凸（LL）和 NoSIJP 组患者术后 LL 和骶骨倾斜度（SS）与术前有显著差异。
现有证据表明，脊柱手术后新发 SIJP 的风险增加与性别、多节段手术、融合至骶骨和术后 PT 增大有关。
