• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.201-206
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• 2013

Objective : To investigate the sagittal sacropelvic morphology and balance of the patients with SIJ pain following lumbar fusion. Methods : Among 452 patients who underwent posterior lumbar interbody fusion between June 2009 and January 2013, patients with postoperative SIJ pain, being responded to SIJ block were enrolled. For a control group, patients matched for sex, age group, the number of fused level and fusion to sacrum were randomly selected. Patients were assessed radiologic parameters including lumbar lordosis, pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). To evaluate the sagittal sacropelvic morphology and balance, the ratio of PT/PI, SS/PI and PT/SS were analyzed. Results : A total of 28 patients with SIJ pain and 56 patients without SIJ pain were assessed. Postoperatively, SIJ pain group showed significantly greater PT (p=0.02) than non-SIJ pain group. Postoperatively, PT/PI and SS/PI in SIJ pain group was significantly greater and smaller than those in non-SIJ pain group respectively (p=0.03, 0.02, respectively) except for PT/SS (p=0.05). SIJ pain group did not show significant postoperative changes of PT/PI and SS/PI (p=0.09 and 0.08, respectively) while non-SIJ pain group showed significantly decrease of PT/PI (p=0.00) and increase of SS/PI (p=0.00). Conclusion : This study presents different sagittal sacropelvic morphology and balance between the patients with/without SIJ pain following lumbar fusion surgery. The patients with SIJ pain showed retroversed pelvis and vertical sacrum while the patients without SIJ pain have similar morphologic features with asymptomatic populations in the literature.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.47-51
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• 2009

Background: The blind sacroiliac joint (SIJ) block cannot always be performed accurately; it is commonly performed in the office based setting because intraarticular and periarticular injections are effective for SIJ pain. However, knowledge on the surface anatomy of the SIJ is lacking. The purpose of this study was to analyze the surface anatomical location of the posterior-inferior margin of the SIJ. Methods: After informed consent was obtained, fifty patients undergoing SIJ block in the prone position were examined. The oblique angles where the anterior-inferior margin and the posterior-inferior margin of the SIJ overlap on X-ray were evaluated. In addition, the surface anatomical relationships between the posterior-inferior margin of the SIJ on X-ray and the posterior superior iliac spine (PSIS) and sacral hiatus by palpation were assessed. Results: The oblique angle was $5.4{\pm}2.9^{\circ}$. The vertical and transverse distance between the posterior-inferior margin of the SIJ and PSIS were $3.8{\pm}0.8cm$ and $0.9{\pm}0.6cm$, respectively. The vertical and transverse distance between the posterior-inferior margin of the SIJ and the midpoint of the sacral hiatus were $3.4{\pm}0.7cm$ and $3.9{\pm}0.6cm$, respectively. Only the vertical distance between the posterior-inferior margin of the SIJ and PSIS showed significant difference between the male and the female groups (P = 0.0016). Conclusions: The measurements in this study can be used as a reference standards for the blind SIJ block.

• PNF and Movement
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• v.8 no.1
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• pp.41-50
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• 2010

Pain originating from the sacroiliac joint(SIJ) has been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction(SID) has been difficult to achieve. Clinical presentation of SID appears that pain and poor performance is responsive to local analgesia of periarticular structures with poorly defined pathology, and poor performance with bony pathological changes present as a result of chronic instability. Previous research indicates that physical examination cannot diagnose SIJ pathology. Earlier studies have not reported sensitivities and specificities of composites of provocation tests known to have acceptable inter-examiner reliability. Tests based on mechanics as manual provocation for SIJ pain have formed the basis of tests used to diagnose SIJ dysfunction. In this review summary, the purpose of this study was to describe the sacroiliac tests with a model of examination, diagnosis, and management of SID. Further research is warranted to determine whether SIJ tests is reliable means of evaluating innominate impairments.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.183-191
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• 2020

Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

• Physical Therapy Korea
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• v.14 no.2
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• pp.61-67
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• 2007

The purpose of this study was to examine inter- and intra-examiner reliability of the sacroiliac joint (SIJ) anatomical landmarks palpation. Two physical therapists and one doctor specializing in rehabilitation examined 22 asymptomatic subjects. They examined anterior superior iliac supine (ASIS), posterior superior iliac supine (PSIS) and iliac crest (IC). For the assessment of intra-examiner reliability, 3 examiners repeated the measurements 3 times over a 2-week interval. Kappa (Kg) yielded intra-examiner reliability that ranged between slight to fair for the ASIS (Kg=.06 to .26; mean Kg=.19), and slight for the PSIS(Kg=-.04 to .18; mean Kg=.07) and slight to fair for the IC (Kg=.06 to .32; mean Kg=.21). Inter-examiner reliability was slight (ASIS Kg=.13; PSIS Kg=.05; IC Kg=.14). These results suggest that the reliability of the assessing SIJ anatomical landmarks using palpation and observation as an indication of SIJ dysfunction still remains questionable. Before this test can be relied upon as an accurate indicator of SIJ dysfunction, it must undergo further research. This further research needs to examine not only reliability, but also validity, sensitivity and specificity.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.6-11
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• 2018

Purpose: The diagnosis of pelvic fractures pattern has become to be essential in the decision making of treatment modality and reducing morbidity and mortality in multiple trauma patients. Sacroiliac joint (SIJ) disruption can cause life-threatening massive arterial bleeding. This study aimed to determine a method of predicting the prognosis and treatment direction with pelvis X-ray alone in the emergency room. We investigated whether SIJ disruption can be used alone as a poor prognostic factor. Methods: We analyzed the medical records and radiologic examination results of 167 patients with pelvic fractures from January 1, 2015 to December 31, 2016 retrospectively. Patients with pathologic fractures, thoraco-abdominal bleeding, and acetabulum fractures and pediatric patients (n=63) were excluded. Factors related to the clinical manifestations and treatments, such as transfusion and surgery, were statistically compared. Results: The cross-sectional analysis showed that there was no correlation between SIJ injury and sex; there were statistically significant relationships between occurrences of shock, conjoined fractures, transfusion, and surgeries. The hospitalization period and partial thromboplastin time and prothrombin time values increased. The logistic regression analysis showed that when an SIJ injury occurred, blood transfusion and hypotension possibilities increased. Conclusions: When pelvic fractures occur near the SIJ, blood transfusion and shock possibilities increase. Physicians must be aware of the high severity and poor prognosis of such fractures when these are diagnosed in the emergency room. And furthermore, the physician has to predict and prepare the intensive care and multidisciplinary approaches.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.17 no.2
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• pp.63-72
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• 2022

Objectives This case study aimed to investigate the effect of complex Korean medicine treatment including Chuna manual therapy on sacroiliac joint (SIJ) pain status post SIJ fusion with sacroiliac screw fixation. Methods Complex Korean medicine treatments including Chuna manual therapy were provided to patients with SIJ widening due to a traffic accident trauma. Measurement of range of motion and manual muscle test to evaluate functional activities of daily living was conducted before and after treatment. Moreover, outcome estimates were performed using the numeric rating scale, pain disability index, and EuroQol 5-dimension five-level questionnaire. Results After complex treatment, functional activities of daily living improved. Sacroiliac joint pain decreased and the quality-of-life score improved. Conclusions This study suggests that treatment with complex Korean medicine treatment including Chuna manual therapy may improve traumatic SIJ widening status post SIJ fusion. A postoperative rehabilitation protocol based on accumulated research results considering a multidisciplinary approach should be prepared to ensure holistic treatment.

• Food Science of Animal Resources
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• v.39 no.3
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• pp.459-473
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• 2019

Lactobacillus rhamnosus GG (LGG) has low resistance to low pH and bile salt in the gastrointestinal juice. In this study, the gel made from whey protein concentrate (WPC) and pullulan (PUL) was used as the wall material to prepare the microencapsulation for LGG protection. The gelation process was optimized and the properties of gel were also determined. The results showed the optimal gel was made from 10% WPC and 8.0% PUL at pH 7.5, which could get the best protective effect; the viable counts of LGG were 6.61 Log CFU/g after exposure to simulated gastric juice (SGJ) and 9.40 Log CFU/g to simulated intestinal juice (SIJ) for 4 h. Sodium dodecyl sulphite polyacrylamide gel electrophoresis (SDS-PAGE) confirmed that the WPC-PUL gel had low solubility in SGJ, but dissolved well in SIJ, which suggested that the gel can protect LGG under SGJ condition and release probiotics in the SIJ. Moreover, when the gel has highest hardness and water-holding capacity, the viable counts of LGG were not the best, suggesting the relationship between the protection and the properties of the gel was non-linear.

• Journal of Korean Society of Steel Construction
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• v.17 no.2 s.75
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• pp.207-216
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• 2005

The maximum strength of the stainless steel square and the circular hollow section columns, which are cold-formed and TIG welded, is experimented on and analyzed. The paper presents centrally compressed experiments, including stub column tests and coupon tests, on stainless steel pipe columns. A total of 24 stainless steel pipe column experiments are conducted, using the slenderness ratios ($L_k/r$ = 20, 30, 40, 50, 60, 70) as parameters. The experimental results were compared with the design standard curves, AIK-LSD and AISC-LRFD, AIJ-LSD, SIJ-ASD curves, and multiple column curves.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.697-706
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• 1998

Motion at the sacroiliac joints(SIJ) has been reported in the medical literature since the mid-19th century. However, for many years authorities vie~d that no movement occurred at the sacroiliac joints and therefore were not clinically significant. Recent contributions from both the basic and clinical sciences caused a change in perception of the role of the sacroiloiac joint in low back pain(LBP). Movement within the sacroiliac joint is now generally recognized, although it is only a small amount. Controversy continues as to the type of motion available and the axes of motion, and continues as to the ability of a clinician to identify a significant sacroiliac dysfunction. Dysfunction of the pelvic girdle is complex and not easily understood. It is common to find serveral dysfunctions within the same pelvic girdle. Each needs to be individually diagnosed and appropriately treated. The diagnostic and therapeutic system designed by Philip E. Greenmam, D. O. allows the operator to deal with any combination of physical findings that are found within the pelvic girdle Restoration of pelvic girdle function within the walking cycle is a major therapeutic goal, particularly from the biomechanical postural-structural model.