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Mikula AL, Fogelson JL, Oushy S, et al. Change in pelvic incidence between the supine and standing positions in patients with bilateral sacroiliac joint vacuum signs. J Neurosurg Spine. 2021;34(4):617-622doi: 10.3171/2020.8.SPINE20742.
Mikula, A. L., Fogelson, J. L., Oushy, S., Pinter, Z. W., Peters, P. A., Abode-Iyamah, K., Sebastian, A. S., Freedman, B., Currier, B. L., Polly, D. W., & Elder, B. D. (2021). Change in pelvic incidence between the supine and standing positions in patients with bilateral sacroiliac joint vacuum signs. Journal of neurosurgery. Spine, 34(4), 617-622. https://doi.org/10.3171/2020.8.SPINE20742
Mikula, Anthony L, et al. "Change in pelvic incidence between the supine and standing positions in patients with bilateral sacroiliac joint vacuum signs." Journal of neurosurgery. Spine vol. 34,4 (2021): 617-622. doi: https://doi.org/10.3171/2020.8.SPINE20742
Mikula AL, Fogelson JL, Oushy S, Pinter ZW, Peters PA, Abode-Iyamah K, Sebastian AS, Freedman B, Currier BL, Polly DW, Elder BD. Change in pelvic incidence between the supine and standing positions in patients with bilateral sacroiliac joint vacuum signs. J Neurosurg Spine. 2021 Jan 15;34(4):617-622. doi: 10.3171/2020.8.SPINE20742. PMID: 33450735.
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J Neurosurg Spine. 2021 Jan 15;34(4):617-622. doi: 10.3171/2020.8.SPINE20742.

Change in pelvic incidence between the supine and standing positions in patients with bilateral sacroiliac joint vacuum signs.

Journal of neurosurgery. Spine

Anthony L Mikula, Jeremy L Fogelson, Soliman Oushy, Zachariah W Pinter, Pierce A Peters, Kingsley Abode-Iyamah, Arjun S Sebastian, Brett Freedman, Bradford L Currier, David W Polly, Benjamin D Elder

Affiliations

  1. Departments of1Neurological Surgery and.
  2. 2Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
  3. 3Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida; and.
  4. 4Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota.

PMID: 33450735 DOI: 10.3171/2020.8.SPINE20742

Abstract

OBJECTIVE: Pelvic incidence (PI) is a commonly utilized spinopelvic parameter in the evaluation and treatment of patients with spinal deformity and is believed to be a fixed parameter. However, a fixed PI assumes that there is no motion across the sacroiliac (SI) joint, which has been disputed in recent literature. The objective of this study was to determine if patients with SI joint vacuum sign have a change in PI between the supine and standing positions.

METHODS: A retrospective chart review identified patients with a standing radiograph, supine radiograph, and CT scan encompassing the SI joints within a 6-month period. Patients were grouped according to their SI joints having either no vacuum sign, unilateral vacuum sign, or bilateral vacuum sign. PI was measured by two independent reviewers.

RESULTS: Seventy-three patients were identified with an average age of 66 years and a BMI of 30 kg/m2. Patients with bilateral SI joint vacuum sign (n = 27) had an average absolute change in PI of 7.2° (p < 0.0001) between the standing and supine positions compared to patients with unilateral SI joint vacuum sign (n = 20) who had a change of 5.2° (p = 0.0008), and patients without an SI joint vacuum sign (n = 26) who experienced a change of 4.1° (p = 0.74). ANOVA with post hoc Tukey test showed a statistically significant difference in the change in PI between patients with the bilateral SI joint vacuum sign and those without an SI joint vacuum sign (p = 0.023). The intraclass correlation coefficient between the two reviewers was 0.97 for standing PI and 0.96 for supine PI (p < 0.0001).

CONCLUSIONS: Patients with bilateral SI joint vacuum signs had a change in PI between the standing and supine positions, suggesting there may be increasing motion across the SI joint with significant joint degeneration.

Keywords: lumbar lordosis; pelvic incidence; sacral; sacroiliac; spinal deformity; spinopelvic parameter; vacuum sign

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