Derek P Lindsey1, Ali Kiapour2, Scott A Yerby1, Vijay K Goel2. 1. SI-BONE, Inc. San Jose, CA. 2. Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, Colleges of Engineering and Medicine, University of Toledo, Toledo, OH.
Abstract
BACKGROUND: Adjacent segment disease is a recognized consequence of fusion in the spinal column. Fusion of the sacroiliac joint is an effective method of pain reduction. Although effective, the consequences of sacroiliac joint fusion and the potential for adjacent segment disease for the adjacent lumbar spinal levels is unknown. The objective of this study was to quantify the change in range of motion of the sacroiliac joint and the adjacent lumbar spinal motion segments due to sacroiliac joint fusion and compare these changes to previous literature to assess the potential for adjacent segment disease in the lumbar spine. METHODS: An experimentally validated finite element model of the lumbar spine and pelvis was used to simulate a fusion of the sacroiliac joint using three laterally placed triangular implants (iFuse Implant System, SI-BONE, Inc., San Jose, CA). The range of motion of the sacroiliac joint and the adjacent lumbar spinal motion segments were calculated using a hybrid loading protocol and compared with the intact range of motion in flexion, extension, lateral bending, and axial rotation. RESULTS: The range of motions of the treated sacroiliac joints were reduced in flexion, extension, lateral bending, and axial rotation, by 56.6%, 59.5%, 27.8%, and 53.3%, respectively when compared with the intact condition. The stiffening of the sacroiliac joint resulted in increases at the adjacent lumbar motion segment (L5-S1) for flexion, extension, lateral bending, and axial rotation, of 3.0%, 3.7%, 1.1%, and 4.6%, respectively. CONCLUSIONS: Fusion of the sacroiliac joint resulted in substantial (> 50%) reductions in flexion, extension, and axial rotation of the sacroiliac joint with minimal (< 5%) increases in range of motion in the lumbar spine. Although the predicted increases in lumbar range of motion are minimal after sacroiliac joint fusion, the long-term clinical results remain to be investigated.
BACKGROUND: Adjacent segment disease is a recognized consequence of fusion in the spinal column. Fusion of the sacroiliac joint is an effective method of pain reduction. Although effective, the consequences of sacroiliac joint fusion and the potential for adjacent segment disease for the adjacent lumbar spinal levels is unknown. The objective of this study was to quantify the change in range of motion of the sacroiliac joint and the adjacent lumbar spinal motion segments due to sacroiliac joint fusion and compare these changes to previous literature to assess the potential for adjacent segment disease in the lumbar spine. METHODS: An experimentally validated finite element model of the lumbar spine and pelvis was used to simulate a fusion of the sacroiliac joint using three laterally placed triangular implants (iFuse Implant System, SI-BONE, Inc., San Jose, CA). The range of motion of the sacroiliac joint and the adjacent lumbar spinal motion segments were calculated using a hybrid loading protocol and compared with the intact range of motion in flexion, extension, lateral bending, and axial rotation. RESULTS: The range of motions of the treated sacroiliac joints were reduced in flexion, extension, lateral bending, and axial rotation, by 56.6%, 59.5%, 27.8%, and 53.3%, respectively when compared with the intact condition. The stiffening of the sacroiliac joint resulted in increases at the adjacent lumbar motion segment (L5-S1) for flexion, extension, lateral bending, and axial rotation, of 3.0%, 3.7%, 1.1%, and 4.6%, respectively. CONCLUSIONS: Fusion of the sacroiliac joint resulted in substantial (> 50%) reductions in flexion, extension, and axial rotation of the sacroiliac joint with minimal (< 5%) increases in range of motion in the lumbar spine. Although the predicted increases in lumbar range of motion are minimal after sacroiliac joint fusion, the long-term clinical results remain to be investigated.
Authors: Paul Park; Hugh J Garton; Vishal C Gala; Julian T Hoff; John E McGillicuddy Journal: Spine (Phila Pa 1976) Date: 2004-09-01 Impact factor: 3.468
Authors: William R Sears; Ioannis G Sergides; Noojan Kazemi; Mari Smith; Gavin J White; Barbara Osburg Journal: Spine J Date: 2011-01 Impact factor: 4.166
Authors: Hector Soriano-Baron; Derek P Lindsey; Nestor Rodriguez-Martinez; Phillip M Reyes; Anna Newcomb; Scott A Yerby; Neil R Crawford Journal: Spine (Phila Pa 1976) Date: 2015-05-01 Impact factor: 3.468
Authors: Arnold Graham Smith; Robyn Capobianco; Daniel Cher; Leonard Rudolf; Donald Sachs; Mukund Gundanna; Jeffrey Kleiner; Milan G Mody; A Nick Shamie Journal: Ann Surg Innov Res Date: 2013-10-30
Authors: Esther P de Kater; Aimée Sakes; Erik Edström; Adrian Elmi-Terander; Gerald Kraan; Paul Breedveld Journal: Eur Spine J Date: 2022-04-05 Impact factor: 2.721
Authors: Donald Sachs; Don Kovalsky; Andy Redmond; Robert Limoni; S Craig Meyer; Charles Harvey; Dimitriy Kondrashov Journal: Med Devices (Auckl) Date: 2016-07-13
Authors: Maziar Ramezani; Stefan Klima; Paul Le Clerc de la Herverie; Jean Campo; Jean-Baptiste Le Joncour; Corentin Rouquette; Mario Scholze; Niels Hammer Journal: Biomed Res Int Date: 2019-01-09 Impact factor: 3.411
Authors: Peter G Whang; Emily Darr; S Craig Meyer; Don Kovalsky; Clay Frank; Harry Lockstadt; Robert Limoni; Andy J Redmond; Philip Ploska; Michael Oh; Abhineet Chowdhary; Daniel Cher; Travis Hillen Journal: Med Devices (Auckl) Date: 2019-09-26