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Sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―Non-fused sacrum vs. fused sacrum
INTRODUCTION: Sacroiliac joint pain (SIJP) after lumbar fusion surgery has recently gained attention as a source of low back pain after lumbar fusion. There are two risk factors for postoperative SIJP, i.e., fusion involving the sacrum and multiple-segment fusion. In this study, we examined whether...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Japanese Society for Spine Surgery and Related Research
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698558/ https://www.ncbi.nlm.nih.gov/pubmed/31440618 http://dx.doi.org/10.22603/ssrr.1.2016-0010 |
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author | Unoki, Eiki Miyakoshi, Naohisa Abe, Eiji Kobayashi, Takashi Abe, Toshiki Shimada, Yoichi |
author_facet | Unoki, Eiki Miyakoshi, Naohisa Abe, Eiji Kobayashi, Takashi Abe, Toshiki Shimada, Yoichi |
author_sort | Unoki, Eiki |
collection | PubMed |
description | INTRODUCTION: Sacroiliac joint pain (SIJP) after lumbar fusion surgery has recently gained attention as a source of low back pain after lumbar fusion. There are two risk factors for postoperative SIJP, i.e., fusion involving the sacrum and multiple-segment fusion. In this study, we examined whether SIJP could occur more frequently in patients with two risk factors (multiple-segment fusion to sacrum). Further, we examined SIJP after multiple-segment (≥3) lumbar fusion, focusing on the difference between floating fusion (non-fused sacrum) and fixed fusion (fused sacrum). METHODS: Ninety-one patients who underwent multiple-segment lumbar fusion were included. Patients without preoperative clinical SIJP were considered. Of these, 17 developed new-onset SIJP. We investigated postoperative SIJP development, duration from surgery to SIJP onset, and postoperative treatment outcomes of SIJP patients using Japanese Orthopaedic Association (JOA) scores. We compared the findings between floating fusion group and fixed fusion group. RESULTS: The incidence of SIJP was significantly higher with fixed fusion (32.1%) than with floating fusion (12.7%). The mean time of onset of sacroiliac joint pain was at 8.63 (2-13) months after surgery in the floating fusion group and 3.78 (1-10) months after surgery in the fixed fusion group, indicating that incidence occurred significantly earlier in the fixed fusion group. Our treatment outcome indicated that the mean JOA score significantly improved in the floating fusion group from 5.13 at the time of onset to 9.50 at the time of final follow-up; however, in the fixed fusion group, it improved from 5.78 at the time of onset to 7.33 at the time of final follow-up, indicating no significant improvement. CONCLUSIONS: In multiple-segment lumbar fusion, fixed fusion (fused sacrum) has a very high risk of SIJP. In addition, the onset of SIJP in such cases may occur earlier. This aspect deserves consideration, given the difficulty of pain treatment. |
format | Online Article Text |
id | pubmed-6698558 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | The Japanese Society for Spine Surgery and Related Research |
record_format | MEDLINE/PubMed |
spelling | pubmed-66985582019-08-22 Sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―Non-fused sacrum vs. fused sacrum Unoki, Eiki Miyakoshi, Naohisa Abe, Eiji Kobayashi, Takashi Abe, Toshiki Shimada, Yoichi Spine Surg Relat Res Original Article INTRODUCTION: Sacroiliac joint pain (SIJP) after lumbar fusion surgery has recently gained attention as a source of low back pain after lumbar fusion. There are two risk factors for postoperative SIJP, i.e., fusion involving the sacrum and multiple-segment fusion. In this study, we examined whether SIJP could occur more frequently in patients with two risk factors (multiple-segment fusion to sacrum). Further, we examined SIJP after multiple-segment (≥3) lumbar fusion, focusing on the difference between floating fusion (non-fused sacrum) and fixed fusion (fused sacrum). METHODS: Ninety-one patients who underwent multiple-segment lumbar fusion were included. Patients without preoperative clinical SIJP were considered. Of these, 17 developed new-onset SIJP. We investigated postoperative SIJP development, duration from surgery to SIJP onset, and postoperative treatment outcomes of SIJP patients using Japanese Orthopaedic Association (JOA) scores. We compared the findings between floating fusion group and fixed fusion group. RESULTS: The incidence of SIJP was significantly higher with fixed fusion (32.1%) than with floating fusion (12.7%). The mean time of onset of sacroiliac joint pain was at 8.63 (2-13) months after surgery in the floating fusion group and 3.78 (1-10) months after surgery in the fixed fusion group, indicating that incidence occurred significantly earlier in the fixed fusion group. Our treatment outcome indicated that the mean JOA score significantly improved in the floating fusion group from 5.13 at the time of onset to 9.50 at the time of final follow-up; however, in the fixed fusion group, it improved from 5.78 at the time of onset to 7.33 at the time of final follow-up, indicating no significant improvement. CONCLUSIONS: In multiple-segment lumbar fusion, fixed fusion (fused sacrum) has a very high risk of SIJP. In addition, the onset of SIJP in such cases may occur earlier. This aspect deserves consideration, given the difficulty of pain treatment. The Japanese Society for Spine Surgery and Related Research 2017-12-20 /pmc/articles/PMC6698558/ /pubmed/31440618 http://dx.doi.org/10.22603/ssrr.1.2016-0010 Text en Copyright © 2017 by The Japanese Society for Spine Surgery and Related Research https://creativecommons.org/licenses/by-nc-nd/4.0/ Spine Surgery and Related Research is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Unoki, Eiki Miyakoshi, Naohisa Abe, Eiji Kobayashi, Takashi Abe, Toshiki Shimada, Yoichi Sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―Non-fused sacrum vs. fused sacrum |
title | Sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―Non-fused sacrum vs. fused sacrum |
title_full | Sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―Non-fused sacrum vs. fused sacrum |
title_fullStr | Sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―Non-fused sacrum vs. fused sacrum |
title_full_unstemmed | Sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―Non-fused sacrum vs. fused sacrum |
title_short | Sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―Non-fused sacrum vs. fused sacrum |
title_sort | sacroiliac joint pain after multiple-segment lumbar fusion: a long-term observational study―non-fused sacrum vs. fused sacrum |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698558/ https://www.ncbi.nlm.nih.gov/pubmed/31440618 http://dx.doi.org/10.22603/ssrr.1.2016-0010 |
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