The iliolumbar ligament: its influence on stability of the sacroiliac joint.
METHODS
In human specimens the influence of the iliolumbar ligament on sacroiliac joint stability was tested during incremental moments applied to the sacroiliac joints.


OBJECTIVE
To assess whether the iliolumbar ligament is able to restrict sacroiliac joint mobility in embalmed cadavers.


BACKGROUND
Firstly, the sacroiliac joint can play an important role in non-specific low back pain; hence, its mobility and stability are of special interest. Secondly, the iliolumbar ligament is considered to be an important source of chronic low back pain. Data on a functional relation between the iliolumbar ligament and sacroiliac joint mobility are lacking.


METHODS
In 12 human specimens an incremental moment was applied to the sacroiliac joint to induce rotation in the sagittal plane. After the assessment of the relationship between rotation angle and moment in the intact situation, specific parts of the iliolumbar ligaments were transected. After each partial transection the measurements were repeated.


RESULTS
Sacroiliac joint mobility in the sagittal plane was significantly increased after a total cut of both iliolumbar ligaments. This increase was in particular due to the transection of a specific part of the iliolumbar ligament, the ventral band.


CONCLUSIONS
The main conclusions are: (a) the iliolumbar ligaments restrict sacroiliac joint sagittal mobility; (b) the ventral band of the iliolumbar ligament contributes most to this restriction.


CONCLUSIONS
In embalmed human cadavers, the mobility of the sacroiliac joint increases after sequential cutting of specific parts of the iliolumbar ligaments. It can be expected that severance of this ligament during surgery will lead to increase of mobility and hence loss of stability of the sacroiliac joint. As a consequence adjacent structures will be affected. This may well be a cause of pain in patients with failed back surgery.
Pool-Goudzwaard
Annelies
A
Department of Biomedical Physics and Technology, Faculty of Medicine and Allied Health Sciences, Erasmus University, Postbus 1738, 3000 DR, Rotterdam, Netherlands. p.m.c.impact@planet.nl
Hoek van Dijke
Gilbert
G
Mulder
Paul
P
Spoor
Cees
C
Snijders
Chris
C
Stoeckart
Rob
R
D000368:Aged; D002102:Cadaver; D005260:Female; D006801:Humans; D007085:Ilium / Q000503:physiopathology*; D066298:In Vitro Techniques; D007593:Joint Instability / Q000503:physiopathology*; D008023:Ligaments, Articular / Q000503:physiopathology* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008297:Male; D016059:Range of Motion, Articular; D012016:Reference Values; D015203:Reproducibility of Results; D012399:Rotation; D012446:Sacroiliac Joint / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D019415:Torque; D016474:Weight-Bearing