Degenerative changes of sacro-iliac joint in patients with lumbar LV–S1 spine fusion
DOI:
https://doi.org/10.15674/0030-59872019114-18Keywords:
sacro-iliac joint, sacro-iliac joint dysfunction, osteophytes, ligaments grafting, bone marrow, subchondral sclerosisAbstract
Objectives: to study the X-ray changes of the sacro-iliac joint (SIJ) in patients with lumbar spine degenerative changes, who had LV–S1 level fusion before and after surgery.
Methods: we made a retrospective analysis of 274 cases of patients with LV–S1 level fusion due to lumbar spine osteochondrosis. The criteria for inclusion in the study were: 1) the presence of anteriorposterior X-ray of the lumbar spine with the SIJ before surgery and on the next follow-up; 2) repeated application after surgical intervention to the Sytenko Institute of Spine and Joint Pathology because of lumbal pelvic pain. 78 case histories were included into the work: group 1 (36 patients) who applied for a lumbar pain for 6 months after surgery, group 2 (42) — one year or more. On X-rays were evaluated articular surfaces of SIJ, subchondral sclerosis, osteophytes, ligaments grafting, bone marrow, narrowing of the width of the articular space of the SIJ. The obtained results were processed statistically.
Results: in most of the included patients, prior to the operation degenerative changes in the SIJ were observed on the anterior-posterior radiographs — narrowing of the articular space width (88.5%) and subchondral sclerosis (87.2 %). In group 1, statistically significant changes in degenerative changes in SIJ have not been determined. In group 2 we observed the progression of degenerative changes: narrowing of articular space — in 97.6 % of patients, increase of subchondral sclerosis — in 95.2 %, increase of osteophyte development — 40.4 %, bone marrow — 69.0 %.
Conclusions: in patients who complain on lumbar pelvic pain after LV–SI spine fusion, differential diagnosis should take into account SIJ dysfunction.
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