Vleeming A, Pool-Goudzwaard A L, Hammudoghlu D, Stoeckart R, Snijders C J, Mens J M
Department of Anatomy, Erasmus University Rotterdam, Netherlands.
Spine (Phila Pa 1976). 1996 Mar 1;21(5):556-62. doi: 10.1097/00007632-199603010-00005.
In embalmed human bodies the tension of the long dorsal sacroiliac ligament was measured during incremental loading of anatomical structures that are biomechanically relevant.
To assess the function of the long dorsal sacroiliac ligament.
In many patients with aspecific low back pain or peripartum pelvic pain, pain is experienced in the region in which the long dorsal sacroiliac ligament is located. It is not well known that the ligament can be easily palpated in the area directly caudal to the posterior superior iliac spine. Data on the functional and clinical importance of this ligament are lacking.
A dissection study was performed on the sacral and lumbar regions. The tension of the long dorsal sacroiliac ligament (n = 12) was tested under loading. Tension was measured with a buckle transducer. Several structures, including the erector spinae muscle, the posterior layer of the thoracolumbar fascia, the sarcotuberous ligament, and the sacrum, were incrementally loaded (with forces of 0-50 newtons). The sacrum was loaded in two directions, causing nutation (ventral rotation of the sacrum relative to the iliac bones) and counternutation (the reverse).
Forced nutation in the sacroiliac joints diminished the tension and forced counternutation increased the tension. Tension in the long dorsal sacroiliac ligament increased during loading of the ipsilateral sacrotuberous ligament and erector spinae muscle. The tension decreased during traction to the gluteus maximus muscle. Tension also decreased during traction to the ipsilateral and contralateral posterior layer of the thoracolumbar fascia in a direction simulating contraction of the latissimus dorsi muscle.
The long dorsal sacroiliac ligament has close anatomical relations with the erector spinae muscle, the posterior layer of the thoracolumbar fascia, and a specific part of the sacrotuberous ligament (tuberoiliac ligament). Functionally, it is an important link between legs, spine, and arms. The ligament is tensed when the sacroiliac joints are counternutated and slackened when nutated. The reverse holds for the sacrotuberous ligament. Slackening of the long dorsal sacroiliac ligament can be counterbalanced by both the sacrotuberous ligament and the erector muscle. Pain localized within the boundaries of the long ligament could indicate among other things a spinal condition with sustained counternutation of the sacroiliac joints. In diagnosing patients with aspecific low back pain or peripartum pelvic pain, the long dorsal sacroiliac ligament should not be neglected. Even in cases of arthrodesis of the sacroiliac joints, tension in the long ligament can still be altered by different structures.
在经过防腐处理的人体尸体上，在对生物力学相关的解剖结构进行递增负荷加载过程中，测量了骶髂背侧长韧带的张力。
评估骶髂背侧长韧带的功能。
在许多患有非特异性下腰痛或围产期骨盆疼痛的患者中，疼痛出现在骶髂背侧长韧带所在的区域。人们并不清楚在髂后上棘正下方的区域很容易触及该韧带。关于该韧带功能和临床重要性的数据尚缺乏。
对骶骨和腰椎区域进行解剖学研究。对12条骶髂背侧长韧带在负荷下进行张力测试。使用扣式传感器测量张力。对包括竖脊肌、胸腰筋膜后层、骶结节韧带和骶骨在内的多个结构进行递增负荷加载（力为0 - 50牛顿）。骶骨在两个方向上加载，导致骶骨前倾（骶骨相对于髂骨的腹侧旋转）和骶骨后倾（相反方向）。
骶髂关节的强制骶骨前倾会降低张力，强制骶骨后倾会增加张力。同侧骶结节韧带和竖脊肌加载时，骶髂背侧长韧带的张力增加。对臀大肌进行牵引时，张力降低。在模拟背阔肌收缩的方向上，对同侧和对侧胸腰筋膜后层进行牵引时，张力也会降低。
骶髂背侧长韧带与竖脊肌、胸腰筋膜后层以及骶结节韧带的特定部分（结节髂韧带）有着密切的解剖关系。在功能上，它是腿部、脊柱和手臂之间的重要连接。当骶髂关节后倾时，该韧带紧张；当骶骨前倾时，韧带松弛。骶结节韧带则相反。骶髂背侧长韧带的松弛可由骶结节韧带和竖脊肌共同平衡。局限于该长韧带边界内的疼痛可能提示除其他情况外，存在骶髂关节持续后倾的脊柱疾病。在诊断患有非特异性下腰痛或围产期骨盆疼痛的患者时，不应忽视骶髂背侧长韧带。即使在骶髂关节融合的情况下，不同结构仍可改变该长韧带的张力。
