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Article: Biomechanical effects of transverse partial sacrectomy on the sacroiliac joints: An in vitro human cadaveric investigation of the borderline of sacroiliac joint instability

TitleBiomechanical effects of transverse partial sacrectomy on the sacroiliac joints: An in vitro human cadaveric investigation of the borderline of sacroiliac joint instability
Authors
KeywordsBiomechanics
Pelvis
Reconstruction
Sacral tumor
Sacrectomy
Issue Date2009
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2009, v. 34 n. 13, p. 1370-1375 How to Cite?
AbstractSTUDY DESIGN. In vitro laboratory study. OBJECTIVE. To measure the effects of transverse partial sacrectomies on the compressive and torsional stiffness of the sacroiliac joints. SUMMARY OF BACKGROUND DATA. Surgical treatment for sacral tumor of different location and nature includes partial or complete sacrectomy. Though the biomechanical investigations about the local destructive force of residual sacrum after partial sacrectomy have been reported, biomechanical properties of the residual sacroiliac joints after different transverse partial sacrectomies remain unknown. METHODS. Seven fresh human cadaveric L5-pelves with normal bone mineral density were used in this study. Each specimen was tested in intact condition first, followed by a series of segmental transverse partial sacrectomies: under S2 partial sacrectomy (U-S2); U-1/2S2; U-S1; U-1/2S1; and right side sacroiliac joint resection (one-side). A material testing machine was used to apply 800 N compression and 7 Nm torsion loads through the L5/S1 joint. The resected dimensional area of sacroiliac joints and structural stiffness of the residual sacroiliac joints were analyzed. RESULTS. Average percentages of the resected area of sacroiliac joints were 8.4% in U-S2, 15.1% in U-1/2S2, 24.8% in U-S1, and 72.3% in U-1/2S1, respectively. In compression U-S2 ∼ one-side preserved 98.7%, 97.1%, 94.4%, 82.9%, and 55.2% of the initial stiffness of the sacroiliac joint, respectively. No significant differences were detected among intact, U-S2, U-1/2S2, and U-S1 (P > 0.05). However, compressive stiffness of U-1/2S1 and one-side was markedly less than that of intact, U-S2, and U-1/2S2 (P < 0.05). In Torsion U-S2 ∼ one-side preserved 90.7%, 88.5%, 81.9%, 71.9%, and 44.5% of the initial sacroiliac joint stiffness, respectively. No significant differences were demonstrated among intact, U-S2, and U-1/2S2 (P > 0.05); However, U-S1, U-1/2S1 and one-side exhibited significantly less torsional stiffness than intact and U-S2 (P < 0.05). CONCLUSION. In surgical treatment of distal sacral tumor, transverse partial sacrectomy involving S1 could result in rotational instability, and the resection level beyond 1/2S1 further led to compressive instability. When the sacrectomy was at or above the S1/2 level, local reconstruction should be considered. © 2009 Lippincott Williams & Wilkins, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/59484
ISSN
2014 Impact Factor: 2.297
ISI Accession Number ID
Funding AgencyGrant Number
HKRGC715306/06E
Funding Information:

Partial support from HKRGC (715306/06E).

References

 

DC FieldValueLanguage
dc.contributor.authorYu, Ben_HK
dc.contributor.authorZheng, Zen_HK
dc.contributor.authorZhuang, Xen_HK
dc.contributor.authorChen, Hen_HK
dc.contributor.authorXie, Den_HK
dc.contributor.authorLuk, KDKen_HK
dc.contributor.authorLu, WWen_HK
dc.date.accessioned2010-05-31T03:51:08Z-
dc.date.available2010-05-31T03:51:08Z-
dc.date.issued2009en_HK
dc.identifier.citationSpine, 2009, v. 34 n. 13, p. 1370-1375en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59484-
dc.description.abstractSTUDY DESIGN. In vitro laboratory study. OBJECTIVE. To measure the effects of transverse partial sacrectomies on the compressive and torsional stiffness of the sacroiliac joints. SUMMARY OF BACKGROUND DATA. Surgical treatment for sacral tumor of different location and nature includes partial or complete sacrectomy. Though the biomechanical investigations about the local destructive force of residual sacrum after partial sacrectomy have been reported, biomechanical properties of the residual sacroiliac joints after different transverse partial sacrectomies remain unknown. METHODS. Seven fresh human cadaveric L5-pelves with normal bone mineral density were used in this study. Each specimen was tested in intact condition first, followed by a series of segmental transverse partial sacrectomies: under S2 partial sacrectomy (U-S2); U-1/2S2; U-S1; U-1/2S1; and right side sacroiliac joint resection (one-side). A material testing machine was used to apply 800 N compression and 7 Nm torsion loads through the L5/S1 joint. The resected dimensional area of sacroiliac joints and structural stiffness of the residual sacroiliac joints were analyzed. RESULTS. Average percentages of the resected area of sacroiliac joints were 8.4% in U-S2, 15.1% in U-1/2S2, 24.8% in U-S1, and 72.3% in U-1/2S1, respectively. In compression U-S2 ∼ one-side preserved 98.7%, 97.1%, 94.4%, 82.9%, and 55.2% of the initial stiffness of the sacroiliac joint, respectively. No significant differences were detected among intact, U-S2, U-1/2S2, and U-S1 (P > 0.05). However, compressive stiffness of U-1/2S1 and one-side was markedly less than that of intact, U-S2, and U-1/2S2 (P < 0.05). In Torsion U-S2 ∼ one-side preserved 90.7%, 88.5%, 81.9%, 71.9%, and 44.5% of the initial sacroiliac joint stiffness, respectively. No significant differences were demonstrated among intact, U-S2, and U-1/2S2 (P > 0.05); However, U-S1, U-1/2S1 and one-side exhibited significantly less torsional stiffness than intact and U-S2 (P < 0.05). CONCLUSION. In surgical treatment of distal sacral tumor, transverse partial sacrectomy involving S1 could result in rotational instability, and the resection level beyond 1/2S1 further led to compressive instability. When the sacrectomy was at or above the S1/2 level, local reconstruction should be considered. © 2009 Lippincott Williams & Wilkins, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subjectBiomechanicsen_HK
dc.subjectPelvisen_HK
dc.subjectReconstructionen_HK
dc.subjectSacral tumoren_HK
dc.subjectSacrectomyen_HK
dc.titleBiomechanical effects of transverse partial sacrectomy on the sacroiliac joints: An in vitro human cadaveric investigation of the borderline of sacroiliac joint instabilityen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0887-9869&volume=34 &issue=13&spage=1370&epage=1375&date=2009&atitle=Biomechanical+effects+of+transverse+partial+sacrectomy+on+the+sacroiliac+joints+an+in+vitro+human+cadaveric+investigation+of+the+borderline+of+sacroiliac+joint+instability.en_HK
dc.identifier.emailLuk, KDK:hcm21000@hku.hken_HK
dc.identifier.emailLu, WW:wwlu@hku.hken_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.identifier.authorityLu, WW=rp00411en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e3181a3d440en_HK
dc.identifier.pmid19478657-
dc.identifier.scopuseid_2-s2.0-67749089378en_HK
dc.identifier.hkuros166591en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-67749089378&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume34en_HK
dc.identifier.issue13en_HK
dc.identifier.spage1370en_HK
dc.identifier.epage1375en_HK
dc.identifier.isiWOS:000266573900004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYu, B=25633299000en_HK
dc.identifier.scopusauthoridZheng, Z=7403007434en_HK
dc.identifier.scopusauthoridZhuang, X=35436325900en_HK
dc.identifier.scopusauthoridChen, H=35227067800en_HK
dc.identifier.scopusauthoridXie, D=34874102700en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK
dc.identifier.scopusauthoridLu, WW=7404215221en_HK

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