Juichi Tonosu, Daisuke Kurosawa, Takako Nishi, Keisuke Ito, Daijiro Morimoto, Yoshiro Musha, Hiroshi Ozawa, Eiichi Murakami

July 2019, Volume 28, Issue 7, pp 1603 - 1609 Original Article Read Full Article 10.1007/s00586-019-05952-z

First Online: 18 March 2019

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


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. [Figure not available: see fulltext.]

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