J Korean Soc Spine Surg.  2019 Dec;26(4):141-150. 10.4184/jkss.2019.26.4.141.

Radiologic Comparison of the Sacroiliac Joint Degeneration Following Lumbar or Lumbosacral Fusion

• Yi J
• Nam WD

• KMID: 2467943
• DOI: http://doi.org/10.4184/jkss.2019.26.4.141

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
To compare the degeneration of sacroiliac joint (SIJ) following lumbar or lumbosacral fusion. SUMMARY OF LITERATURE REVIEW: The SIJ is adjacent to lumbosacral junction and its degeneration can be the potential cause of pain. However, the study addressing SIJ degeneration following lumbar or lumbosacral fusion is very limited.
MATERIALS AND METHODS
From June 2002 to June 2012, 98 patients who underwent posterior decompression and posterolateral fusion were included in this study. The study group was divided into 2 groups according to the range of fusion. Group A had fusion to L5 and included 34 patients. Group B had fusion to S1 and included 64 patients. We evaluated the five years postoperative radiologic and clinical outcomes retrospectively.
RESULTS
There was no statistically significant difference of bilateral preoperative subchondral sclerosis and osteophytes of the SIJ between group A and group B. However, group B revealed statistically significant subchondral sclerosis and osteophyte formation of the SIJ than group A on every radiographs after postoperative 1 year. In group B, the number of fusion segments and age were statistically positively correlated with the degeneration of the SIJ.
CONCLUSIONS
Degeneration of the SIJ revealed more rapid and more severe progression in lumbosacral fusion group than in lumbar fusion group. The number of fusion segments and age were positively correlated with the degeneration of the SIJ in lumbosacral fusion group. Therefore, these facts should be taken into account when performing spinal fusion.

Keyword

Lumbar degenerative disease; Posterolateral fusion; Sacroiliac joint; Adjacent segment disease

MeSH Terms

Decompression
Humans
Osteophyte
Retrospective Studies
Sacroiliac Joint*
Sclerosis
Spinal Fusion

Figure

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  Fig. 1. Postoperative radiograph of 64 year-old woman who experienced lumbosacral fusion shows subchondral sclerosis of bilateral sacroiliac joint. Dotted lines show the total sacroiliac joint lines and solid lines note the range of subchondral sclerosis. Subchondral sclerosis of right and left sacroiliac joint was calculated as 74%, 82%, respectively.

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  Fig. 2. Postoperative radiograph of 49 year-old woman who experienced lumbosacral fusion shows prominent osteophyte of bilateral sacroiliac joint. The right and left osteophytes measured 9.0 mm and 7.4 mm respectively.

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  Fig. 3. A 69-year-old female patient who underwent L3-S1 posterolateral fusion. Sequential radiographs (A) preoperative, (B) postoperative 6 months, (C) postoperative 1 year, (D) Postoperative 3 years, (E) Postoperative 5 years) show the development of subchondral sclerosis and osteophytes of the sacroiliac joints.

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