1.Clinical Incidence of Sacroiliac Joint Arthritis and Pain after Sacropelvic Fixation for Spinal Deformity.
Seiji OHTORI ; Takeshi SAINOH ; Masashi TAKASO ; Gen INOUE ; Sumihisa ORITA ; Yawara EGUCHI ; Junichi NAKAMURA ; Yasuchika AOKI ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Gen ARAI ; Hiroto KAMODA ; Miyako SUZUKI ; Gou KUBOTA ; Yoshihiro SAKUMA ; Yasuhiro OIKAWA ; Masashi YAMAZAKI ; Tomoaki TOYONE ; Kazuhisa TAKAHASHI
Yonsei Medical Journal 2012;53(2):416-421
PURPOSE: Sacroiliac fixation using iliac screws for highly unstable lumbar spine has been reported with an improved fusion rate and clinical results. On the other hand, there is a potential for clinical problems related to iliac fixation, including late sacroiliac joint arthritis and pain. MATERIALS AND METHODS: Twenty patients were evaluated. Degenerative scoliosis was diagnosed in 7 patients, failed back syndrome in 6 patients, destructive spondyloarthropathy in 4 patients, and Charcot spine in 3 patients. All patients underwent posterolateral fusion surgery incorporating lumbar, S1 and iliac screws. We evaluated the pain scores, bone union, and degeneration of sacroiliac joints by X-ray imaging and computed tomography before and 3 years after surgery. For evaluation of low back and buttock pain from sacroiliac joints 3 years after surgery, lidocaine was administered in order to examine pain relief thereafter. RESULTS: Pain scores significantly improved after surgery. All patients showed bone union at final follow-up. Degeneration of sacroiliac joints was not seen in the 20 patients 3 years after surgery. Patients showed slight low back and buttock pain 3 years after surgery. However, not all patients showed relief of the low back and buttock pain after injection of lidocaine into the sacroiliac joint, indicating that their pain did not originate from sacroiliac joints. CONCLUSION: The fusion rate and clinical results were excellent. Also, degeneration and pain from sacroiliac joints were not seen within 3 years after surgery. We recommend sacroiliac fixation using iliac screws for highly unstable lumbar spine.
Aged
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Arthritis/*surgery
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Bone Screws
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Female
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Humans
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Low Back Pain/diagnosis/epidemiology
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Lumbar Vertebrae/*surgery
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Male
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Middle Aged
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Pain/diagnosis/*epidemiology
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Sacroiliac Joint/*immunology/*pathology
2.The Comparison Between Behcet's Disease and Spondyloarthritides: Does Behcet's Disease Belong to the Spondyloarthropathy Complex?.
Hyun Kyu CHANG ; Deok Hee LEE ; Seung Mun JUNG ; Soo Jung CHOI ; Jeong Uk KIM ; Young Joon CHOI ; Seung Ki BAEK ; Kyeong Soo CHEON ; Eun Hee CHO ; Kyoung Sook WON
Journal of Korean Medical Science 2002;17(4):524-529
This study was to clarify whether Behcet's disease (BD) could be classified into the spondyloarthropathy (SpA) complex. It was undertaken on 58 patients with BD (BD group), 56 patients with SpA (SpA group), and 3 patients who concurrently satisfied the criteria for BD and SpA (BDSpA group). The clinical parameters and known susceptible HLA antigens were compared between BD group and SpA group. In addition, 3 patients in BDSpA group were reviewed. The prevalence of definitive sacroiliitis (SI) in BD group and SpA group was 46.4% and 5.2%, respectively. However, none had a definitive SI in healthy controls. Enthesitis was observed in 3.4% of BD group and in 50% of SpA group. The patterns of eye involvement were different between these two groups. HLA-B27 was negative in all 49 patients of BD group, whereas it was positive in 67.9% of SpA group. The prevalence of HLA-B51 was 51.7% in BD group, and that in SpA group was 21.4%. One patient in BDSpA group was considered to have concurrent BD and ankylosing spondylitis (AS). Another patient was closer to AS, and the third to BD. Conclusively, it seems that BD could not be classified into the SpA complex.
Adult
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Behcet Syndrome/*classification/immunology/pathology
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Eye/pathology
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Female
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HLA-B Antigens/analysis/immunology
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HLA-B27 Antigen/analysis/immunology
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Humans
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Lumbar Vertebrae/pathology/radiography
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Pelvis
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Radioactive Tracers
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Sacroiliac Joint/pathology/radiography
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*Spondylarthritis/immunology/pathology
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Tomography, Emission-Computed, Single-Photon