Stress-strain state of the kinematic chain «lumbar spine – sacrum – pelvis» in cases of asymmetry of articular gaps of the sacroiliac joint

Mykola Korzh, Volodymyr Staude, Andrey Kondratyev, Mykhaylo Karpinsky

Abstract


In the kinematic chain of the skeleton its important parts trans­mitting the load from the spine to the pelvis are the sacrum, the sacroiliac joints (SIJ) and ligaments surrounding them. SIJ dysfunction often leads to low back pain.

 

Objective: To analyze the stress-strain state of SCJ with ventral, dorsal and interosse­ous sacroiliac ligaments at their normal condition and in cases of asymmetry of the joint space width.

 

Methods: for the study the previously proposed virtual model synthesized and based on the lumbar spine, SIJ and pelvis CT scans of 20 patients and SIJ MRI scans of 10 patients was selected. Finite element model of the lumbosacral spine and SIJ were loaded from the upper vertebrae LI with vertical force of 400 N and 2000 N along the axis of the spine.

 

Results: distribution of stress and strain in the SIJ and lumbosacral spine model obtained under conditions of asymmetry of joint spaces’ width indicates the changing in nature of functioning of the entire articulation. In the case of asymmetry of SIJ width asymmetry it was determined displace­ment of conventional axis of rotational mobility of the sacrum and significant redistribution of stresses and strains between the left and right joints and ligaments. While loading with 400 N for asymmetric joint space width it was determined an increasing of the value of tension in SIJ ligaments on the left and of the value of deformation on the right particularly in dorsal and interosseous sacroiliac ligaments. The values of tension in the sacrospinous, sacrotuberous and iliolumbar ligaments changed asymmetrically so as to maximally compensate violations caused by asymmetry of the joint space width. The same trends were found while loading with 2000 N but at the same time tensions in sacrospinous and sacrotuberous ligaments significantly increased indicating their important role in SIJ stabilization under conditions of increasing load. In the proposed SIJ with lumbar spine model mathematically substantiated an opportunity of nascence of functional deforma­tion like «twisted pelvis».


Keywords


sacroiliac joints; lumbar spine; sacrum; ligaments

References


Schwarzer A. C. The sacroiliac joint in chronic low back pain / A. C. Schwarzer, C. N. Aprill, N. Bogduk / Spine. — 1995. — Vol. 20 (1). — P. 31–37.

Maigne J. Y. Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain / J. Y. Maigne, A. Aivaliklis, F. Pfefer / Spine. — 1996. — Vol. 21 (16). — P. 1889–1892.

The value of medical history and physical examination in diagnosing sacroiliac joint pain / P. Dreyfuss, M. Michaelson, K. Pauza [et al.] / Spine. — 1996. — Vol. 21 (22). — P. 2594–2602.

Diagnosing painfull sacroiliac joints: A validity study of a McKenzie evaluation and sacroiliac provocation tests / M. Laslett, S. B. Young, C. N. Aprill, B. Mc Donald / Aust. J. Physiother. — 2003. — Vol. 49 (2). — P. 89–97.

Mobility of the sacroilac joint in the elderly: A kinetic and radiology study / A. Vleeming, J. P. Van Wingerden, P. Dijkstra [et al.] // Clin. Biomech. — 1992. — Vol. 7 (3). — P. 170–176, doi: 10.1016/0268-0033(92)90032-Y.

Anatomical variants with joint space measurments on CT / M. Demir, A. Mavi, E. Gumusburun [et al.] // Kobe J. Med. Sci. — 2007 — Vol. 53 (5). — P. 209–217.

Dihlmann W. Diagnostic radiology of the sacroiliac joints / W. Dihlmann. — NY: Georg Thieme Verlag, 1980. — 157 p.

Prognostic value of asymetrie laxity of the sacroiliac joints in pregnancy related pelvic pain / L. Damon, H. M. Buyruk, F. Guler-Uysal [et al.] // Spine. — 2002. — Vol. 27 (24). — P. 2820–2824.

Staude V.A. Numerical simulation and analysis of the stress-strain state of sacro-iliac joint in different variants of lumbar lordisis / Staude V.A., Kondratyev A.V., Karpinsky M. Yul./ Orthopedics, Travmatology and prosthetics — 2012. — № 2 (587). — С. 50–56, doi: http://dx.doi.org/10.15674/0030-59872012250-56.

Staude V.A. Numerical simulation and analysis of the stress-strain state of sacro-iliac joint with main ligaments / Staude V.A., Kondratyev A.V., Karpinsky M. Yul./ Orthopedics, Travmatology and prosthetics — 2015. — № 1 (598). — С. 34–41, doi: http://dx.doi.org/10.15674/0030-59872015134-41.

Kapandzhy A. I. Spine. Joint fixation. Mechanic schemes of human body with comments. / A. I. Kapandzhy/ 6 — th edition.- M.”Aksmo”, 2009, — P. 334.

Masi A. Anatomical, biomechanical and clinical perspectives on sacroiliac joints: an integrative synthesis of biodynamic mechanisms related to ankylosing spondylitis / A. Masi, M. Benjamin, A. Vleeming // Movement, stability and lumbopelvic pain: integration of research and therapy // Vleeming A, Mooney V, Stoeckhart R, eds.. — Edinburg: Churchill livingstone, 2007. — P. 205–227.

Berezovsky V. A. Biophysical characteristics human tissues: reference book /Berezovsky V. A., Kolotilov N. N./ K.: Naukova dumka, 1990. — 224 p.

Finite element methods in spine biomechanics research / L. G. Gilbertson, V. K. Goel, W. Z. Kong [et al.] // CRC Crit Rev Biomed Eng. — 1995. — № 23 (Pt. 5–6). — P. 411–473.

Alyamovsky A. A. Solid Works/COSMOS Works. Engineering analysis by finit element method /A. A. Alyamovsky. — M: DMK Press, 2004. — 432 p.

The biomechanics of back pain / M. Adams, M. Bogduk, K. Burton, P. Dolan– 2nd edition. — Edinburg: Churchill Livingstone, 2007. — 336 p.

Popov G. I. Biomechanics of human movement activity / G. I. Popov, А. V. Samsonova. — М.: «Аkademiya», 2011. — 320 с.

Don Tigny R. L. Critical analysis of the functional dynamics of the sacroiliac joints as they pertain to normal gait / R. L. Don Tigny // J. Orthop. Med. — 2005. — Vol. 27 (1). — P. 3–9.

Gracovetsky S. Analysis and interpretation of gait in relation to lumbopelvic function / S. Gracovetsky: proceeding of the Fourth Interdisciplinary World Congress on Low Back a Pelvic Pain. — Montreal, Canada. ECO, Roterdam, 2001. — P. 45–63.




DOI: https://doi.org/10.15674/0030-5987201535-13

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