Sacroiliac Joint Syndrome 10 Years after Lumbar Arthroplasty: The Importance of Spinopelvic Alignment

Abstract

Introduction Sagittal balance is an independent predictor of outcomes in spinal care and several authors focused their attention on the lumbar lordosis restoration as the key point to prevent secondary sacroiliac joint dysfunction (SIJD) after fusion. On the other hand, lumbar disc arthroplasty allows preservation of motion avoiding increased stress on the spinopelvic junction and preventing iatrogenic sagittal imbalance. Methods We analyze the incidence of a secondary SIJD and the spinopelvic alignment on a series of 31 consecutive lumbar disc prosthesis with a 10-year follow-up. Results Sagittal balance assessment showed no significant variation of preoperative spinopelvic parameters. Four patients (12%) presented a symptomatic SIJD. Only two of them required a percutaneous SIJ fixation. Both of them presented a fused L5–S1 prosthesis. Conclusions Very few studies are focused on the topic of SIJ deterioration after lumbar arthroplasty and, at the best of our knowledge, the present article is the first with such a long follow-up. After 10 years of the surgery 12% of our patients presented a symptomatic SIJ dysfunction, less than the percentage reported in the literature after lumbosacral fusion. The low rate of SIJD 10 years after lumbar arthroplasty might be explained by the preservation of the spinopelvic balance.