European Spine Journal

, Volume 28, Issue 7, pp 1603–1609 | Cite as

The association between sacroiliac joint-related pain following lumbar spine surgery and spinopelvic parameters: a prospective multicenter study

  • Juichi TonosuEmail author
  • Daisuke Kurosawa
  • Takako Nishi
  • Keisuke Ito
  • Daijiro Morimoto
  • Yoshiro Musha
  • Hiroshi Ozawa
  • Eiichi Murakami
Original Article



To prospectively calculate the incidence of postoperative sacroiliac joint-related pain (SIJP) and investigate the association between spinopelvic parameters and postoperative SIJP after lumbar spine surgery.


We prospectively enrolled consecutive patients who underwent lumbar spine surgery. We defined postoperative SIJP as unilateral buttock pain according to fulfillment of the following criteria within 3 months of the surgery: a sacroiliac joint (SIJ) score higher than 4/9 postoperatively; positive response to analgesic periarticular SIJ injection with fluoroscopy; no other complications related to the surgery. The patients were divided into the SIJP group and non-SIJP group. We compared the background information and analyzed the differences in spinopelvic parameters in both groups. Additionally, receiver-operating characteristic curve analyses were performed to evaluate the cutoff values of spinopelvic parameters.


Of the 281 patients enrolled, 265 were included and eight developed postoperative SIJP (3.0%). There were no significant differences in the background information between groups. Preoperative and postoperative radiological evaluations revealed that the pelvic incidence (PI) in the SIJP group was significantly higher than that in the non-SIJP group, and there were no significant differences in lumbar lordosis (LL), pelvic tilt, sacral slope, and PI minus LL. For preoperative PI, the area under the curve, cutoff value, sensitivity, and specificity were 0.73739, 59, 62.5%, and 81.9%, respectively.


The incidence of postoperative SIJP after lumbar spine surgery was 3.0%. Higher PI values were associated with a higher risk of postoperative SIJP.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Sacroiliac joint-related pain Lumbar spine surgery Postoperative pain Spinopelvic parameters Pelvic incidence 



We thank the medical clerks at the hospitals for collecting the data.

Compliance with ethical standards

Conflict of interest

All authors have no conflict of interests to declare.

Supplementary material

586_2019_5952_MOESM1_ESM.pptx (167 kb)
Supplementary material 1 (PPTX 167 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Juichi Tonosu
    • 1
    Email author
  • Daisuke Kurosawa
    • 2
  • Takako Nishi
    • 3
  • Keisuke Ito
    • 4
  • Daijiro Morimoto
    • 5
  • Yoshiro Musha
    • 4
  • Hiroshi Ozawa
    • 6
  • Eiichi Murakami
    • 2
  1. 1.Department of Orthopedic SurgeryKanto Rosai HospitalKawasaki CityJapan
  2. 2.Department of Orthopaedic Surgery/Low Back Pain and Sacroiliac Joint CenterJCHO Sendai HospitalSendaiJapan
  3. 3.Department of Orthopedic SurgeryYoshida Orthopedic HospitalToyotaJapan
  4. 4.Department of Spine SurgeryToho University Ohashi HospitalTokyoJapan
  5. 5.Department of Neurological SurgeryNippon Medical SchoolTokyoJapan
  6. 6.Department of Orthopaedic Surgery, Faculty of MedicineTohoku Medical and Pharmaceutical UniversitySendaiJapan

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