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The Effects of Abdominal Obesity and Sagittal Imbalance on Sacroiliac Joint Pain After Lumbar Fusion – Lumbar Fusion

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The article examines the risk factors for postoperative sacroiliac joint pain (SIJP) after a posterior lumbar interbody fusion (PLIF). The study found that abdominal obesity and sagittal imbalance were significant predictors of SIJP. Patients with abdominal obesity also showed higher levels of inflammatory markers and pain intensity. The study suggests that more attention should be given to body shape and lumbar lordosis correction angles before lumbar surgery. However, the study acknowledges limitations in the uniform diagnosis of SIJP, which may affect the accuracy of the incidence rate. PMID: 38285036

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spinal facility on Harley Street UK

Published article

S: The significant predictors of SIJP were abdominal obesity and sagittal imbalance. Patients with abdominal obesity showed higher levels of inflammatory markers and pain intensity. More attention should be paid to body shape and the angle of correction of lumbar lordosis before lumbar surgery.

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Pain Physician. 2024 Jan;27(1):59-67.ABSTRACTBACKGROUND: Postoperative sacroiliac joint pain (SIJP) is a common manifestation of failed back surgery syndrome after a posterior lumbar interbody fusion (PLIF). However, there is currently no consensus on the risk factors for SIJP after PLIF.OBJECTIVES: We explored the effects of abdominal obesity and sagittal imbalance on SIJP after PLIF.STUDY DESIGN: This,

Pain Physician. 2024 Jan;27(1):59-67.

ABSTRACT

BACKGROUND: Postoperative sacroiliac joint pain (SIJP) is a common manifestation of failed back surgery syndrome after a posterior lumbar interbody fusion (PLIF). However, there is currently no consensus on the risk factors for SIJP after PLIF.

OBJECTIVES: We explored the effects of abdominal obesity and sagittal imbalance on SIJP after PLIF.

STUDY DESIGN: This is a prospective observational cohort study.

SETTING: This study occurred at the Department of Spinal Surgery at a hospital affiliated with a medical university.

METHODS: A total of 401 patients who underwent PLIF from June 2018 to June 2021 were enrolled in this study. 36 patients experienced postoperative SIJP. In contrast, a matched group comprised 72 non-SIJP patients. We used 1:2 propensity score matching to compare obesity features and sagittal spine parameters in the 2 groups. Inflammatory cytokines and visual analog scale (VAS) scores were measured in the SIJP group.

RESULTS: A total of 36 patients (8.98%) experienced SIJP during the follow-up. Compared with the non-SIJP group, patients with postoperative SIJP had a higher body mass index (BMI), greater abdominal obesity, a higher incidence of pelvic incidence-lumbar lordosis greater than 10°, and a higher incidence of a sagittal vertical axis greater than 5 cm (P < 0.05). Receiver operating characteristic curve analysis showed that the area under the curve for waist circumference was greater than that for BMI (0.762 vs. 0.650, P = 0.049). Logistic regression analysis revealed that the risk factors for SIJP were abdominal obesity, a pelvic incidence-lumbar lordosis of greater than 10°, and a sagittal vertical axis greater than 5 cm (P < 0.05). In patients with SIJP, interleukin 6, tumor necrosis factor-α, and VAS scores were higher in the abdominal obesity group than in the non-abdominal obesity group (P < 0.05).

LIMITATIONS: There was no uniform diagnosis of SIJP, so the incidence rate of SIJP might not be accurate.

S: The significant predictors of SIJP were abdominal obesity and sagittal imbalance. Patients with abdominal obesity showed higher levels of inflammatory markers and pain intensity. More attention should be paid to body shape and the angle of correction of lumbar lordosis before lumbar surgery.

PMID:38285036

The London Spine Unit : most established spinal facility on Harley Street UK

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The Effects of Abdominal Obesity and Sagittal Imbalance on Sacroiliac Joint Pain After Lumbar Fusion

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Pain Physician. 2024 Jan;27(1):59-67.ABSTRACTBACKGROUND: Postoperative sacroiliac joint pain (SIJP) is a common manifestation of failed back surgery syndrome after a posterior lumbar interbody fusion (PLIF). However, there is currently no consensus on the risk factors for SIJP after PLIF.OBJECTIVES: We explored the effects of abdominal obesity and sagittal imbalance on SIJP after PLIF.STUDY DESIGN: This
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