Abstract
The relationship between degenerative changes of the sacroiliac joints and the lumbar spine on CT has not been studied yet. The aim of this analysis is to determine the nature of their association as well as the influence of fixed anatomical spinopelvic parameters on sacroiliac joint degeneration. For this institutional review-board-approved investigation, imaging datasets as well as electronic medical records of 719 patients without back pain from the clinical routine of our department of radiology were included. Age, sex, weight category (slim, normal, obese), parity in women and indication for imaging were noted for all patients. The presence of degenerative lesions of the lumbar spine (disc degeneration, endplate degeneration, spondylophytes, and facet joint osteoarthritis) was noted separately at each lumbar segment (L1 to L5). Sacroiliac joints were assessed for sclerosis and osteophytes. Fixed anatomical spinopelvic parameters were measured: pelvic radius = PR; pelvic incidence = PI; sacral table angle = STA. Correlation as well as regression analyses were performed; data were analyzed for males and females separately. PI increased significantly with age in both women and men, while STA decreased and PR remained constant; neither of them was associated with SIJ degeneration. SIJ degeneration correlated with disc degeneration (tau = 0.331; p < 0.001), spondylophytes (tau = 0.397; p < 0.001), and facet joint degeneration (tau = 0.310; p < 0.001) in men, but with no parameter of spinal degeneration in women. Lumbar spinal degeneration increased the risk of sacroiliac joint degeneration in men significantly (OR 7.2; 95%CI 2.8–19.0), but it was not a significant covariable in women. Fixed spinopelvic parameters have little impact on sacroiliac joint degeneration. The degeneration of the sacroiliac joints and the lumbar spine appear to be parallel processes in men, but are largely unrelated in women.
Highlights
The sacroiliac joint (SIJ) is one of the most important mechanical axes of the human body, responsible for the transmission of force from the lower extremities to the lumbar spine [1]
It is the key parameter for the assessment of the sagittal profile by using the Global Alignment and Proportion (GAP) score, which predicts mechanical complications in patients undergoing spinal deformity correction [7]
To the best of our knowledge, this is the first investigation of the association of quantitative anatomical parameters of the pelvis and degeneration of the lumbar spine with sacroiliac joint degeneration in a large cohort of the normal population
Summary
The sacroiliac joint (SIJ) is one of the most important mechanical axes of the human body, responsible for the transmission of force from the lower extremities to the lumbar spine [1]. The degenerative or mechanical disease of the SIJ, which may be the root cause of low back pain in as many as 30% of patients [4,5], is still challenging to assess clinically [6]. The pelvic incidence is of great importance in the restoration of the sagittal profile in adult spinal deformity surgery. It is the key parameter for the assessment of the sagittal profile by using the Global Alignment and Proportion (GAP) score, which predicts mechanical complications in patients undergoing spinal deformity correction [7]
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