Radiometric parameters of the sacrum and pelvis in patients with dysfunctions of the sacroiliac joint, affecting the spinae-pelvic balance in the frontal plane
DOI:
https://doi.org/10.15674/0030-59872017354-62Keywords:
sacro-iliac joint, basal sacral bone, pelvic inclination, inclination of sacral boneAbstract
Objective: to study the radiographic parameters of the sacrum and pelvis in patients with dysfunction of the sacroiliac joint, which affects the spinal-pelvic balance in the frontal plane and their interrelation.
Methods: 50 patients aged 20 to 71 years with sacroiliac joint dysfunction were included in the survey. Standing X-rays were analyzed: 1) the angle of sacral cranial plate inclinationby the method of R. E. Irvin; 2) pelvic tilt angle; 3) angle of rotation of the sacrumthe axial axis by the method of O. M. Orla; 4) the width of the articular clefts of the sacroiliac joint in the ventral, medial and dorsal parts. Indicators were calculated statistically.
Results: in 25 patients (50 %) deviations in all positions were found to be less than 3°, in 6 (12 %) — more than 3°, in 5 (10 %) — the maximum inclination of the sacrum. Most of the subjects (90 %) had an asymmetry of the width of the articular clefts of the sacroiliac joint, which averaged (3.5 ± 1.1) mm. The subjects are divided into 4 clusters: I — with a high degree of asymmetry of the width of the articular surfaces in the ventral section, negligible in the medial and dorsal, with a large inclination of the sacrum and pelvis, with a large rotation of the sacrum; ІІ — with practically symmetrical width of articular surfaces in all threears, inclination of the pelvis and sacrum, a large rotation of the spacecraft; III — with a significant asymmetry of the width of the articular cracks in the medial section and small in the dorsal, large inclination of the pelvis and sacrum, with a large rotation of the sacrum; IV — with a large asymmetry of the width of articular surfaces in the dorsal part and minimal in the ventral and medial parts, small inclination of the sacrum and pelvis, with a small rotation of the sacrum.
Conclusions: in the majority of patients (90 %), the asymmetry of the width of the articular surfaces of the sacroiliac joint was revealed, in the rest — pelvic inclination, inclination and rotation of the sacrum. The inclination of the sacrum was recorded in 78 % of patients, the pelvis — 84 %, the rotation of the sacrum — in 92 %. An unfavorable prognosis was found in patients with I, III and IV clusters — 60 % of all surveyed.References
- Мaigne JY, Aivaliklis A, Pfefer F.Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine. 1996;21:1889-92.
- Schwarzer AC, Aprill CN, Bogduk N. The sacroiliac joint in chronic low back pain. Spine. 1995;20:31-7.
- Irvin RE, Vleeming А, Mooney V, Stoeckart R. Why and how to optimize posture. Lumbopelvic Pain Integration of Research and Therapy. Chyrchill Livingstone, Edinburg, 2007;16:239-51.
- Korzh M, Staude V, Kondratyev A, Karpinsky M. Stress-strain state of the system «lumbar spine-sacrum-pelvis» in the conditions of front pelvis. Orthopаedics, Travmatology and Рrosthetics 2016;1(602):54–62. doi: 10.15674/0030-59872016154-61. (in Russian)
- Korzh M, Staude V, Kondratyev A, Karpinsky M. Stress-strain state of the kinematic chain «lumbar spine – sacrum – pelvis» in cases of asymmetry of articular gaps of the sacroiliac joint. Orthopаedics, Travmatology and Prosthetics. 2015;3(600):5–14. doi: 10.15674/0030-5987201535-13. (in Russian)
- Hammer N, Steinke H, Lingslebe U. Ligamentous influence in pelvic load distribution. Spine J.2013;13(10):1321-30. doi: 10.1016/j.spinee.2013.03.050.
- Laslett M, Young SB, Aprill CN, McDonald B. Diagnosing painfull sacroiliac joints: A validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust. J Physiother. 2003;49:89-97.
- Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17:794-819. doi: 10.1007/s00586-008-0602-4.
- Perlman R, Golan J, Lugo M. Diagnosis of sacroiliac joint syndrome in low back/pelvic pain: reliability of 3 key clinical signs. In 9th Interdisciplinary World Congress on Low Back & Pelvic Pain, Singapore October 31- November 4, 2016, рр. 408-9.
- StaudeVA, Radzishevska YeB, Zlatnyk RV. Radiometric parameters of the sacrum and pelvis, affecting the spine and pelvic balance in the frontal plane, in healthy volunteers. Orthopаedics, Traumatology and Prosthetics. 2017;2(607):52–61. DOI: 10.15674/0030-59872017252-6. (in Russian)
- Orel АМ. Spine X-ray examination for manual therapeutist. Vidar, 2007. 311 p.(in Russian)
- Gracovetsky S, Vleeming A, Mooney V, Stoeckart R. Stability or controlled instability? In: Lumbopelvic Pain Integration of Research and Therapy.Chyrchill Livingstone, Edinburg, 2007;19:290-3.
- Don Tigny RL, Vleeming A, Mooney V, Stoeckart R. A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology. In: Lumbopelvic Pain Integration of Research and Therapy. Chyrchill Livingstone, Edinburg, 2007;19:290-3.
- Mc Gill SM, Grenier S, Kacic N, Cholewicki J. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol. 2003 Aug;13(4):353-9.
- Palesy PD. Tendon and ligament insertions – a possible source of musculoskeletal pain. J. Craniomandibular Practic 1997;15:194-202.
- Benjamin M, Toumi H, Ralphs JR, Bydder G, Best TM, Milz S. Where tendons and ligaments meet bone; attachment sites (enthesis) in relation to exercise and/or mechanical load. J Anat. 2006;208:471-90. doi: 10.1111/j.1469- 7580.2006.00540.x.
- Mc Kay Unique mechanism for lumbar musculoskeletal pain defined from primary care research into periosteal enthesis response to biomechanical stress and formation of small fibre polyneuropathy. In 9th Interdisciplinary World Congress on Low Back & Pelvic Pain, Singapore October 31- November 4, 2016. р. 384
- Ravin T, Vleeming A, Mooney V, Stoeckart R. Visualization of pelvic biomechanical dysfunction. In: Lumbopelvic Pain Integration of Research and Therapy. Chyrchill Livingstone, Edinburg, 2007;20:335.
- Demir M, Mavi A, Gümüsburun E, Bayram M, Gürsoy S, Nishio H. Anatomical Variations with Joint Space Measurements on CT. Kobe J Med Sci.2007;53(5):209-217
- Dijkstra PF, Vleeming A, Mooney V, Stoeckart R. Basic problems in the visualization of the sacroiliac joint. In: Lumbopelvic Pain Integration of Research and Therapy.Chyrchill Livingstone, Edinburg, 2007;20:305.
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