Sacroiliac joint pain (SIJP) after lumbar/Lumbosacral fusion: Our experience

Authors

  • Shahbaz Khan Ziauddin university hospital
  • Dr.Nida Hameed Ziauddin university hospital Karachi
  • Dr. Saood Jawed
  • Prof. Sohail Rafi
  • Prof. Imtiaz hashmi

Abstract

Objective: To evaluate risk factors for SIJP following lumbar or Lumbosacral fusion in our population.

Methods:  This retrospective study was conducted in Orthopedic and Spine department of Ziauddin University hospital Karachi. Patients meeting inclusion criteria were included. Incidence of SIJ pain following lumbosacral fusion surgery and its associated risk factors were assessed.

Results: 597 patients were included, 256(42.9%) were males and 341(57.1%) were females with mean age of 58.3 +/- 14 years. L4-L5 was most common involved segment in 49.1% cases followed by L3-L4 (30.5%) and L5-S1 (10.1%). Floating fusion was performed in 401 (67.2%) cases while fixed fusion was performed in 196(32.8%). Lumbar canal stenosis was most common diagnosis followed by LDH and spondylolisthesis. SIJ pain developed in 81 (13.6%) patients within 6-12 months in most of cases. Significant relationship was found between SIJ pain with more than 3 levels lumbar fusion (p-value=0.000), fixed fusion involving S1 (67/81 pts, p-value=0.000). No significant association was found between SIJ pain with age, gender, smoking, comorbidities, spinopelvic balance and degenerative scoliosis.

Conclusion: Multilevel fusion and fixed fusion are interrelated risk factors for development of post operative SIJ pain.

Keywords: Spinal Stenosis, Spinal Fusion,Pedicle Screws, Sacroiliac Joint,

Author Biographies

Dr.Nida Hameed, Ziauddin university hospital Karachi

Orthopedic and spine department (Post graduate resident)

Dr. Saood Jawed

Post graduate resident Orthopedics 

Prof. Sohail Rafi

HOD Orthopedics and Spine surgery 

Ziauddin University hospital 

Prof. Imtiaz hashmi

Professor of Orthopedics and Spine surgery 

Ziauddin University hospital Karachi 

References

References

Ücer M, Aydin I, Tacyildiz AE, Dogan I, Emel E. Surgical outcomes of decompressive laminectomy by transspinous approach for degenerative lumbar spinal stenosis. Magnetic resonance imaging. 2018;68(1618).

Baloch SR. Functional Outcomes After Lumbar Fusion for Degenerative Spine Using Oswestry Disability Index. A Retrospective Observational Study. EC Orthopaedics. 2021;12.

Deyo RA, Nachemson A, Mirza SK. Spine-fusion surgery: the case for restraint. N Engl J Med 2004;350:722–6.

Tye EY, Anderson J, Haas A, Percy R, Woods ST, Ahn N. Decompression versus decompression and fusion for degenerative lumbar stenosis in a workers'compensation setting. Spine. 2017;42(13):1017–1023.

Maigne JY, Planchon CA. Sacroiliac joint pain after lumbar fusion: a study with anesthetic blocks. Eur Spine J 2005;14: 654–8.

DePalma MJ, Ketchum JM, Saullo TR. Etiology of chronic low back pain in patients having undergone lumbar fusion. Pain Med 2011;12:732–9.

Unoki E, Abe E, Murai H, Kobayashi T, Abe T. Fusion of multiple segments can increase the incidence of sacroiliac joint pain after lumbar or lumbosacral fusion. Spine. 2016 Jun 15;41(12):999-1005.

Ivanov AA, Kiapour A, Ebraheim NA, et al. Lumbar fusion leads to increases in angular motion and stress across sacroiliac joint: a finite element study. Spine (Phila Pa 1976) 2009;34:E162-9.

Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother. 2013;13:99-116.

Murakami E, Tanaka Y, Aizawa T, et al. Effect of periarticular and

intraarticular lidocaine injections for sacroiliac joint pain: prospective comparative study. J Orthop Sci 2007;12:274–80.

Foley BS, Buschbacher RM. Sacroiliac joint pain: anatomy, biomechanics, diagnosis, and treatment. Am J Phys Med Rehabil 2006;85:997–1006.

Laslett M, Aprill CN, McDonald B, et al. Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 2005;10:207–18.

Murakami E, Aizawa T, Noguchi K, et al. Diagram specific to sacroiliac joint pain site indicated by one-finger test. J Orthop Sci 2008;13:492–7

Liliang PC, Lu K, Liang CL, et al. Sacroiliac joint pain after lumbar and lumbosacral fusion: findings using dual sacroiliac joint blocks. Pain Med 2011;12:565–70.

Ha KY, Lee JS, Kim KW. Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion. Spine (Phila Pa 1976) 2008;33:1192–8.

Downloads

Published

2022-03-14

How to Cite

Khan, S., Dr.Nida Hameed, Dr. Saood Jawed, Prof. Sohail Rafi, & Prof. Imtiaz hashmi. (2022). Sacroiliac joint pain (SIJP) after lumbar/Lumbosacral fusion: Our experience. Journal of Pakistan Orthopaedic Association, 34(01), 27–30. Retrieved from http://jpoa.org.pk/index.php/upload/article/view/596