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Biomechanical analysis of the number of implants for the immediate sacroiliac joint fixation

  • Biomechanics
  • Published:
Spine Deformity Aims and scope Submit manuscript

Abstract

Purpose

The fusion of the sacroiliac joint (SIJ) is the last treatment option for chronic pain resulting from sacroiliitis. With the various implant systems available, there are different possible surgical strategies in terms of the type and number of implants and trajectories. The aim was to quantify the effect of the number of cylindrical threaded implants on SIJ stabilization.

Methods

Six cadaveric pelvises were embedded in resin simulating a double-leg stance. Compression loads were applied to the sacral plate. The pelvises were tested non-instrumented and instrumented progressively with up to three cylindrical threaded implants (12-mm diameter, 60-mm length) with a posterior oblique trajectory. Vertical (VD) and angular (AD) displacements of the SIJ were measured locally using high-precision cameras and digital image correlation.

Results

Compared to the non-instrumented initial state, instrumentation with one implant significantly decreased the VD (− 24% ± 15%, p = 0.028), while the AD decreased on average by − 9% (± 15%; p = 0.345). When compared to the one-implant configuration, adding a second implant further statistically decreased VD (− 10% ± 7%, p = 0.046) and AD (− 19% ± 15, p = 0.046). Adding a third implant did not lead to additional stabilization for VD nor AD (p > 0.5).

Conclusion

Compared to the non-instrumented initial state, the two-implant configuration reduces both vertical and angular displacements the most, while minimizing the number of implants.

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Availability of data and materials

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

The authors acknowledge the support of Dr Kathia Chaumoître, MD, and the Assistance Publique-Hôpitaux de Marseille, (Hôpital Nord, Marseille, France) for their radiologic expertise.

Funding

This study was financially supported by the Fonds de Recherche du Québec—Nature et Technologies, the A*MIDEX foundation and the Technologies and the Natural Sciences and Engineering Research Council of Canada (Industrial Research Chair program with Medtronic of Canada, IRCPJ 346145-16).

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, Polytechnique Montréal, P.O. Box 6079, Downtown Station, Montreal, QC, H3C 3A7, Canada

    Roxanne Dubé-Cyr, Carl-Éric Aubin & Isabelle Villemure

  2. Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montreal, QC, H3T 1C5, Canada

    Roxanne Dubé-Cyr, Carl-Éric Aubin & Isabelle Villemure

  3. iLab-Spine (International Laboratory-Spine Imaging and Biomechanics), Montreal, Canada

    Roxanne Dubé-Cyr, Carl-Éric Aubin & Isabelle Villemure

  4. iLab-Spine (International Laboratory-Spine Imaging and Biomechanics), Marseille, France

    Roxanne Dubé-Cyr & Pierre-Jean Arnoux

  5. Laboratoire de Biomécanique Appliquée, IFSTTAR, LBA UMR T24, Aix-Marseille Université, Boulevard Pierre Dramard, Marseille Cedex, France

    Roxanne Dubé-Cyr & Pierre-Jean Arnoux

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  1. Roxanne Dubé-Cyr
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  4. Pierre-Jean Arnoux
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Contributions

RD-C: (1) made substantial contributions to the conception of the work, acquisition, analysis and interpretation of data; (2) drafted the work; (3) approved the version to be published; (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. C-ÉA: (1) made substantial contributions to the conception of the work and interpretation of data; (2) revised the work critically for important intellectual content; (3) approved the version to be published; (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. IV: (1) made substantial contributions to the conception of the work and interpretation of data; (2) revised the work critically for important intellectual content; (3) approved the version to be published; (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. P-JA: (1) made substantial contributions to the conception of the work and interpretation of data; (2) revised the work critically for important intellectual content; (3) approved the version to be published; (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Carl-Éric Aubin.

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Conflict of interest

Dr. Aubin reports grants from Natural Sciences and Engineering Research Council of Canada (Industrial Research Chair program with Medtronic of Canada), non-financial support from Medtronic, during the conduct of the study; grants from Medtronic, grants from Natural Sciences and Engineering Research Council of Canada, grants from Canada First Research Excellence Funds, outside the submitted work. Dr. Dubé-Cyr has nothing to disclose. Dr. Villemure has nothing to disclose. Dr. Arnoux has nothing to disclose.

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Polytechnique Montreal: CÉR-1617-30.

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Specimens used in this study gave an informed consent to donate their body to science.

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Dubé-Cyr, R., Aubin, CÉ., Villemure, I. et al. Biomechanical analysis of the number of implants for the immediate sacroiliac joint fixation. Spine Deform 9, 1267–1273 (2021). https://doi.org/10.1007/s43390-021-00325-3

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  • DOI: https://doi.org/10.1007/s43390-021-00325-3

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