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

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TitleBiomechanical effects of transverse partial sacrectomy on the sacroiliac joints: An in vitro human cadaveric investigation of the borderline of sacroiliac joint instability
AuthorsYu, B2
Zheng, Z2
Zhuang, X2
Chen, H2
Xie, D2
Luk, KDK1
Lu, WW1
KeywordsBiomechanics
Pelvis
Reconstruction
Sacral tumor
Sacrectomy
Issue Date2009
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
CitationSpine, 2009, v. 34 n. 13, p. 1370-1375 [How to Cite?]
DOI: http://dx.doi.org/10.1097/BRS.0b013e3181a3d440
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.
ISSN0362-2436
2011 Impact Factor: 2.078
2011 SCImago Journal Rankings: 0.137
DOIhttp://dx.doi.org/10.1097/BRS.0b013e3181a3d440
ISI Accession Number IDWOS:000266573900004
Funding AgencyGrant Number
HKRGC715306/06E
Funding Information:

Partial support from HKRGC (715306/06E).

ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorYu, B
dc.contributor.authorZheng, Z
dc.contributor.authorZhuang, X
dc.contributor.authorChen, H
dc.contributor.authorXie, D
dc.contributor.authorLuk, KDK
dc.contributor.authorLu, WW
dc.date.accessioned2010-05-31T03:51:08Z
dc.date.available2010-05-31T03:51:08Z
dc.date.issued2009
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.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationSpine, 2009, v. 34 n. 13, p. 1370-1375 [How to Cite?]
DOI: http://dx.doi.org/10.1097/BRS.0b013e3181a3d440
dc.identifier.doihttp://dx.doi.org/10.1097/BRS.0b013e3181a3d440
dc.identifier.epage1375
dc.identifier.hkuros166591
dc.identifier.isiWOS:000266573900004
Funding AgencyGrant Number
HKRGC715306/06E
Funding Information:

Partial support from HKRGC (715306/06E).

dc.identifier.issn0362-2436
2011 Impact Factor: 2.078
2011 SCImago Journal Rankings: 0.137
dc.identifier.issue13
dc.identifier.openurl
dc.identifier.pmid19478657
dc.identifier.scopuseid_2-s2.0-67749089378
dc.identifier.spage1370
dc.identifier.urihttp://hdl.handle.net/10722/59484
dc.identifier.volume34
dc.languageeng
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
dc.publisher.placeUnited States
dc.relation.ispartofSpine
dc.relation.referencesReferences in Scopus
dc.subjectBiomechanics
dc.subjectPelvis
dc.subjectReconstruction
dc.subjectSacral tumor
dc.subjectSacrectomy
dc.titleBiomechanical effects of transverse partial sacrectomy on the sacroiliac joints: An in vitro human cadaveric investigation of the borderline of sacroiliac joint instability
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong
  2. Sun Yat-Sen University