Effect of sacroiliac fusion on gait, standing balance, and pelvic mobility for unilateral sacroiliac joint dysfunction.

Balance analysis Center of pressure Functional outcome measures Gait analysis Pain avoidant behavior Range of motion Sacroiliac joint dysfunction Sacroiliac joint fusion

Journal

North American Spine Society journal
ISSN: 2666-5484
Titre abrégé: N Am Spine Soc J
Pays: United States
ID NLM: 9918335076906676

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 30 08 2023
accepted: 16 10 2023
medline: 29 11 2023
pubmed: 29 11 2023
entrez: 29 11 2023
Statut: epublish

Résumé

Sacroiliac joint fusion (SIF) has been shown to effectively alleviate pain and improve functional deficits associated with sacroiliac joint dysfunction (SIJD). Previous studies have demonstrated significant improvements in gait function, however, none have reported both over-ground walking and quiescent standing, and additionally, none have included analysis of pelvic kinematics which may contain important information regarding pain avoidant compensatory behaviors. The purpose of this study was to identify objective functional differences between symptomatic and asymptomatic sides of unilateral sacroiliac joint dysfunction (SIJD) patients and to demonstrate the effectiveness of unilateral sacroiliac fusion (SIF) to improve gait and balance function compared to matched controls. Thirteen unilateral SIJD patients were evaluated before and 6 months after SIF and were compared to matched asymptomatic controls. Pain and disability were assessed using visual analog scales and the Oswestry disability index respectively. Over ground walking and standing balance were assessed using 3D joint kinematics and kinetic ground reaction force analyses. Preoperatively, SIJD patients reported high levels of pain and disability and exhibited significant deficits in gait including elevated step width, reduced hip flexion/extension, and elevated pelvic motion as well as elevated center of pressure sway characteristics during standing. After unilateral SIF, patients reported significant reductions in pain and demonstrated significant improvements in gait including normalization of step width between sides and improved hip motion however elevated pelvic obliquity and rotation motion remained. Improvements in standing balance included reduced coronal sway characteristics and normalization of loading symmetry between sides. Unilateral SIF resulted in significant improvements in both gait and balance function among SIJD patients to levels comparable to matched controls, however elevated pelvic motion remained. These findings help inform surgeons on the effectiveness of SIF for unilateral SIJD and provide important information regarding interpretation of functional outcomes.

Sections du résumé

Background UNASSIGNED
Sacroiliac joint fusion (SIF) has been shown to effectively alleviate pain and improve functional deficits associated with sacroiliac joint dysfunction (SIJD). Previous studies have demonstrated significant improvements in gait function, however, none have reported both over-ground walking and quiescent standing, and additionally, none have included analysis of pelvic kinematics which may contain important information regarding pain avoidant compensatory behaviors. The purpose of this study was to identify objective functional differences between symptomatic and asymptomatic sides of unilateral sacroiliac joint dysfunction (SIJD) patients and to demonstrate the effectiveness of unilateral sacroiliac fusion (SIF) to improve gait and balance function compared to matched controls.
Methods UNASSIGNED
Thirteen unilateral SIJD patients were evaluated before and 6 months after SIF and were compared to matched asymptomatic controls. Pain and disability were assessed using visual analog scales and the Oswestry disability index respectively. Over ground walking and standing balance were assessed using 3D joint kinematics and kinetic ground reaction force analyses.
Results UNASSIGNED
Preoperatively, SIJD patients reported high levels of pain and disability and exhibited significant deficits in gait including elevated step width, reduced hip flexion/extension, and elevated pelvic motion as well as elevated center of pressure sway characteristics during standing. After unilateral SIF, patients reported significant reductions in pain and demonstrated significant improvements in gait including normalization of step width between sides and improved hip motion however elevated pelvic obliquity and rotation motion remained. Improvements in standing balance included reduced coronal sway characteristics and normalization of loading symmetry between sides.
Conclusion UNASSIGNED
Unilateral SIF resulted in significant improvements in both gait and balance function among SIJD patients to levels comparable to matched controls, however elevated pelvic motion remained. These findings help inform surgeons on the effectiveness of SIF for unilateral SIJD and provide important information regarding interpretation of functional outcomes.

Identifiants

pubmed: 38025937
doi: 10.1016/j.xnsj.2023.100288
pii: S2666-5484(23)00090-2
pmc: PMC10666026
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100288

Informations de copyright

© 2023 The Authors.

Déclaration de conflit d'intérêts

One or more authors declare potential competing financial interests or personal relationships as specified on required ICMJE-NASSJ Disclosure Forms.

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Auteurs

Damon Mar (D)

University of Kansas Medical Center, 3901 Rainbow Blvd., Delp 5040, Mail Stop 3017, Kansas City, KS 66160, USA.

Kyle Robinson (K)

Texas Back Institute, 6020 W. Parker Rd., Plano, TX 75093, USA.

Bethany Wilson (B)

Texas Back Institute, 6020 W. Parker Rd., Plano, TX 75093, USA.

Ralph Rashbaum (R)

Texas Back Institute, 6020 W. Parker Rd., Plano, TX 75093, USA.

Classifications MeSH