Two articles on PainSci cite Dall 2019: 1. The Complete Guide to Low Back Pain 2. Spinal Fracture Bracing
PainSci notes on Dall 2019:
For this experiment, SIJ ligaments in cadavers were severed, roughly doubling the joint’s range of motion. Screwing it back together decreased the instability but did not eliminate it. Even a more elaborate rig of screws and fixation rods could not fully restore the stability of the intact joint. This failure to stabilize big, complex joints is also seen with other kinds of spinal fixation: see Spinal Fracture Bracing
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: Sacroiliac joint hypermobility or aberrant mechanics may be a source of pain. The purpose of this study was to assess sacroiliac joint range of motion after simulated adjacent lumbosacral instrumented fusion, with or without sacroiliac joint fusion, with lateral sacroiliac screws.
METHODS: In this in vitro biomechanical study, seven cadaveric specimens were tested on a six-degrees-of-freedom machine under load control. Left posterior sacroiliac joint ligaments were severed to maximize joint range of motion. Influence of lumbosacral instrumentation on sacroiliac joint motion, with or without fixation, was studied.
FINDINGS: During flexion-extension in the setting of posterior sacroiliac joint injury and L5-S1 fixation, sacroiliac joint range of motion increased to 195% of intact. After fixation with lateral sacroiliac screws, average range of motion reduced to 144% of intact motion. Sacroiliac joint screws thus partially stabilized the joint and reduced motion. Use of 6 bilateral sacroiliac joint screws with L5-S1 screw and rod fixation in lateral bending and axial rotation yielded the greatest reduction in range of motion. Without lumbosacral fixation, baseline motion of the sacroiliac joint was reduced, and sacroiliac joint screw alone, using either 2, 3, or 6 screws, was able to restore motion at or below the level of an intact joint.
INTERPRETATION: Sacroiliac joint ligament injury with existing lumbosacral fixation doubled sacroiliac joint range of motion, but thereafter, fixation with lateral sacroiliac screws decreased range of motion of the injured sacroiliac joint. Screw configuration played a minor role, but generally, 6 sacroiliac joint screws had the greatest motion reduction.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study. Kasch 2022 Spine (Phila Pa 1976).
- A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Yousef 2013 Anaesthesia.
- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.
- Sudden amnesia resulting in pain relief: the relationship between memory and pain. Choi 2007 Pain.
- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.