title: Transient sacroiliac joint-related pain is a common problem following lumbar decompressive surgery without instrumentation.
abstract: OBJECTIVE
  Patients with lumbar stenosis profit substantially from decompressive surgery. The change of body position and walking behaviour after successful surgery might lead to changed force effects on the entire spine and on the sacroiliac joint (SIJ). We analyzed the incidence of postoperative SIJ-related pain.
  
  
  METHODS
  The authors analyzed the records of 100 consecutive patients from three institutions, who underwent decompressive surgery without instrumentation. The diagnosis of SIJ-related pain was confirmed by periarticular infiltration. The radiological changes of the sacroiliac joint were assessed in plain radiographs in both groups: patients with SIJ pain (group 1) and patients without SIJ pain (group 2) after surgery.
  
  
  RESULTS
  22 patients required medical attention due to SIJ-related pain after surgery. While the walking distance increased substantially in both groups without difference (p=0.150), the analysis of overall satisfaction favoured group 2 (p=0.047). Female patients suffered more from SIJ pain after surgery (p=0.036). Age, severity of radiological changes or number of operated segments appeared not to trigger SIJ-related pain.
  
  
  CONCLUSIONS
  The adaptation of a changed body posture and gait could lead to transient overload of the SIJ and surrounding myofascial structures. The patients should be informed about this possible condition to avoid uncertainty, discontent, unnecessary diagnostics and to induce a quick, specific treatment. Non-diagnosed sacroiliac joint-related pain could be a possible, but reversible reason for the diagnosis of a "failed-back-surgery".
authors.affiliation: Department of Neurosurgery, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Schomacher
authors.affiliation: Centre for Orthopedics and Surgery Wittenau, Berlin, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Kunhardt
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Bundeswehrkrankenhaus Berlin, Berlin, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Koeppen
authors.affiliation: Department of Neurosurgery, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
authors.forename: Dag
authors.initials: D
authors.lastname: Moskopp
authors.affiliation: Joint Spine Centre, Vivantes Auguste Viktoria Klinikum, Berlin, Germany.
authors.forename: Heino
authors.initials: H
authors.lastname: Kienapfel
authors.affiliation: Department of Orthopedic Surgery, Sana Kliniken Sommerfeld, Kremmen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kroppenstedt
authors.affiliation: Joint Spine Centre, Vivantes Auguste Viktoria Klinikum, Berlin, Germany. Electronic address: mario.cabraja@vivantes.de.
authors.forename: Mario
authors.initials: M
authors.lastname: Cabraja
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging*; D013130:Spinal Stenosis / Q000601:surgery*
keywords: Pain; Sacroiliac joint; Spine; Surgery