Sacroiliac Joint Degeneration and Pain After Spinal Arthrodesis: A Systematic Review.
Journal
Clinical spine surgery
ISSN: 2380-0194
Titre abrégé: Clin Spine Surg
Pays: United States
ID NLM: 101675083
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
received:
23
08
2021
accepted:
09
04
2022
medline:
4
5
2023
pubmed:
14
5
2022
entrez:
13
5
2022
Statut:
ppublish
Résumé
This was a systematic review. The present study aims to review the available literature concerning sacroiliac joint (SIJ) pain and degeneration after lumbosacral fixation to identify the prevalence and potential risk factors. Although numerous factors can predispose patients to SIJ degeneration and pain various clinical studies indicate lumbosacral arthrodesis as a major cause. The PubMed-MEDLINE, Cochrane Central Registry of Controlled Trials, and Embase Biomedical database were searched. Peer-reviewed comparative studies, cohort studies, case series studies and case control studies, conducted either in a retrospective or prospective design, that registered data about SIJ pain and degeneration after lumbosacral fixation were included. Twenty-one studies including 2678 patients met the inclusion criteria. The percentage of SIJ pain after lumbosacral fixation diagnosed with injections and physical examination varied widely, from 3% to 90%. Among patients who underwent spinal fusion, SIJ pain prevalence was higher when arthrodesis was fixed compared with floating fusions (59% vs. 10%, P -value >0.05). The prevalence of SIJ degenerative changes at computed tomography scan was more frequent in patients who underwent spinal arthrodesis than in those who did not (75% vs. 38.2%, P -value ≤0.05). According to current evidence, patients who received lumbosacral fixation are at risk of SIJ pain. Number of fused levels, involvement of pelvis or sacrum in the arthrodesis area, inadequate lumbosacral sagittal alignment, and site of bone graft harvesting could be possible risk factor leading to sacroiliac degeneration and pain after lumbar spine fixation that should be investigated by physicians. However, there is a lack of homogeneity of the studies that address the problem, therefore, further prospective comparative studies, with a homogeneous architecture and cohorts are needed. Level III.
Sections du résumé
STUDY DESIGN
This was a systematic review.
OBJECTIVE
The present study aims to review the available literature concerning sacroiliac joint (SIJ) pain and degeneration after lumbosacral fixation to identify the prevalence and potential risk factors.
SUMMARY OF BACKGROUND DATA
Although numerous factors can predispose patients to SIJ degeneration and pain various clinical studies indicate lumbosacral arthrodesis as a major cause.
MATERIALS AND METHODS
The PubMed-MEDLINE, Cochrane Central Registry of Controlled Trials, and Embase Biomedical database were searched. Peer-reviewed comparative studies, cohort studies, case series studies and case control studies, conducted either in a retrospective or prospective design, that registered data about SIJ pain and degeneration after lumbosacral fixation were included.
RESULTS
Twenty-one studies including 2678 patients met the inclusion criteria. The percentage of SIJ pain after lumbosacral fixation diagnosed with injections and physical examination varied widely, from 3% to 90%. Among patients who underwent spinal fusion, SIJ pain prevalence was higher when arthrodesis was fixed compared with floating fusions (59% vs. 10%, P -value >0.05). The prevalence of SIJ degenerative changes at computed tomography scan was more frequent in patients who underwent spinal arthrodesis than in those who did not (75% vs. 38.2%, P -value ≤0.05).
CONCLUSION
According to current evidence, patients who received lumbosacral fixation are at risk of SIJ pain. Number of fused levels, involvement of pelvis or sacrum in the arthrodesis area, inadequate lumbosacral sagittal alignment, and site of bone graft harvesting could be possible risk factor leading to sacroiliac degeneration and pain after lumbar spine fixation that should be investigated by physicians. However, there is a lack of homogeneity of the studies that address the problem, therefore, further prospective comparative studies, with a homogeneous architecture and cohorts are needed.
LEVEL OF EVIDENCE
Level III.
Identifiants
pubmed: 35551147
doi: 10.1097/BSD.0000000000001341
pii: 01933606-202305000-00005
doi:
Types de publication
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
169-182Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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