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Biomechanical effects of transverse partial sacrectomy on the sacroiliac joints: an in vitro human cadaveric investigation of the borderline of sacroiliac joint instability.
Spine (Phila Pa 1976). 2009 Jun 01; 34(13):1370-5.S

Abstract

STUDY 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-(1/2)S2; U-S1; U-(1/2)S1; 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-(1/2)S2, 24.8% in U-S1, and 72.3% in U-(1/2)S1, respectively. In compression U-S2 approximately 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-(1/2)S2, and U-S1 (P > 0.05). However, compressive stiffness of U-(1/2)S1 and one-side was markedly less than that of intact, U-S2, and U-(1/2)S2 (P < 0.05). In Torsion U-S2 approximately 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-(1/2)S2 (P > 0.05); However, U-S1, U-(1/2)S1 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 (1/2)S1 further led to compressive instability. When the sacrectomy was at or above the S1/2 level, local reconstruction should be considered.

Authors+Show Affiliations

Department of Spine Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. hpyubinsheng@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19478657

Citation

Yu, Binsheng, et al. "Biomechanical Effects of Transverse Partial Sacrectomy On the Sacroiliac Joints: an in Vitro Human Cadaveric Investigation of the Borderline of Sacroiliac Joint Instability." Spine, vol. 34, no. 13, 2009, pp. 1370-5.
Yu B, Zheng Z, Zhuang X, et al. Biomechanical effects of transverse partial sacrectomy on the sacroiliac joints: an in vitro human cadaveric investigation of the borderline of sacroiliac joint instability. Spine. 2009;34(13):1370-5.
Yu, B., Zheng, Z., Zhuang, X., Chen, H., Xie, D., Luk, K. D., & Lu, W. W. (2009). Biomechanical effects of transverse partial sacrectomy on the sacroiliac joints: an in vitro human cadaveric investigation of the borderline of sacroiliac joint instability. Spine, 34(13), 1370-5. https://doi.org/10.1097/BRS.0b013e3181a3d440
Yu B, et al. Biomechanical Effects of Transverse Partial Sacrectomy On the Sacroiliac Joints: an in Vitro Human Cadaveric Investigation of the Borderline of Sacroiliac Joint Instability. Spine. 2009 Jun 1;34(13):1370-5. PubMed PMID: 19478657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biomechanical effects of transverse partial sacrectomy on the sacroiliac joints: an in vitro human cadaveric investigation of the borderline of sacroiliac joint instability. AU - Yu,Binsheng, AU - Zheng,Zhaomin, AU - Zhuang,Xinming, AU - Chen,Hui, AU - Xie,Denghui, AU - Luk,K D K, AU - Lu,W W, PY - 2009/5/30/entrez PY - 2009/5/30/pubmed PY - 2009/9/26/medline SP - 1370 EP - 5 JF - Spine JO - Spine VL - 34 IS - 13 N2 - STUDY 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-(1/2)S2; U-S1; U-(1/2)S1; 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-(1/2)S2, 24.8% in U-S1, and 72.3% in U-(1/2)S1, respectively. In compression U-S2 approximately 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-(1/2)S2, and U-S1 (P > 0.05). However, compressive stiffness of U-(1/2)S1 and one-side was markedly less than that of intact, U-S2, and U-(1/2)S2 (P < 0.05). In Torsion U-S2 approximately 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-(1/2)S2 (P > 0.05); However, U-S1, U-(1/2)S1 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 (1/2)S1 further led to compressive instability. When the sacrectomy was at or above the S1/2 level, local reconstruction should be considered. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/19478657/Biomechanical_effects_of_transverse_partial_sacrectomy_on_the_sacroiliac_joints:_an_in_vitro_human_cadaveric_investigation_of_the_borderline_of_sacroiliac_joint_instability_ L2 - http://dx.doi.org/10.1097/BRS.0b013e3181a3d440 DB - PRIME DP - Unbound Medicine ER -