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Adjacent segment disease on hip joint as a complication of spinal fusion surgery including sacroiliac joint fixation

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Abstract

Purpose

Recently, the number of adult spinal deformity surgeries including sacroiliac joint fixation (SIJF) by using an S2 alar iliac screw or iliac screw has increased to avoid the distal junctional failure. However, we occasionally experienced patients who suffered from hip pain after a long instrumented spinal fusion. We hypothesized that long spinal fusion surgery including SIJF influenced the hip joint as an adjacent joint. The aim of this paper was to evaluate the association between spinal deformity surgery including SIJF and radiographic progression of hip osteoarthritis (OA).

Methods

This study was retrospective cohort study. In total, 118 patients who underwent spinal fusion surgery at single center from January 2013 to August 2018 were included. We measured joint space width (JSW) at central space of the hip joint. We defined reduction of more than 0.5 mm/year in JSW as hip OA progression. The patients were divided into two groups depending on either a progression of hip osteoarthritis (Group P), or no progression (Group N).

Results

The number of patients in Group P and Group N was 47 and 71, respectively. Factor that was statistically significant for hip OA was SIJF (p = 0.0065, odds ratio = 7.1, 95% confidence interval = 1.6–31.6). There were no other significant differences by the multiple logistic regression analysis.

Conclusion

This study identified spinal fixation surgery that includes SIJF as a predictor for radiographic progression of hip OA over 12 months. We should pay attention to hip joint lesions after adult spinal deformity surgery, including SIJF.

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Availability of data and materials

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

Code availability

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

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Funding

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Authors and Affiliations

  1. Department of Orthopeadic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, Japan

    Takuhei Kozaki, Hiroshi Hashizume, Daisuke Nishiyama, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Yasutsugu Yukawa, Akihito Minamide, Takaya Taniguchi, Keiji Nagata, Daisuke Fukui, Hidenobu Tamai, Ryo Taiji, Shizumasa Murata & Hiroshi Yamada

  2. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan

    Hiroyuki Oka

Authors
  1. Takuhei Kozaki
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  2. Hiroshi Hashizume
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  3. Daisuke Nishiyama
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  4. Hiroshi Iwasaki
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  6. Masanari Takami
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  8. Akihito Minamide
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  9. Takaya Taniguchi
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  11. Daisuke Fukui
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  14. Shizumasa Murata
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  15. Hiroyuki Oka
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  16. Hiroshi Yamada
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Contributions

TK and HH designed and performed the experiments, derived the models and analyzed the data. IH, ST, and MT performed surgical procedure. YY, AM, HO and HY encouraged TK to investigate and supervised the findings of this work. KN, RT, and SM assisted with measurements. TK wrote the manuscript in consultation with all authors.

Corresponding author

Correspondence to Hiroshi Hashizume.

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Conflict of interest

None of the authors have any conflict of interest to declare.

Ethics approval

All patients provided informed consent prior to surgery, and the study protocol was approved by the institutional ethical committee of Wakayama Medical University.

Consent to participate

All patients provided informed consent prior to surgery.

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All patients provided informed consent for publication.

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Cite this article

Kozaki, T., Hashizume, H., Nishiyama, D. et al. Adjacent segment disease on hip joint as a complication of spinal fusion surgery including sacroiliac joint fixation. Eur Spine J 30, 1314–1319 (2021). https://doi.org/10.1007/s00586-020-06700-4

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  • DOI: https://doi.org/10.1007/s00586-020-06700-4

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