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Novel Insights Into the Sacroiliac Joint Ligaments

Steinke, Hanno, PhD*; Hammer, Niels, Cand Med*; Slowik, Volker, PhD; Stadler, Jörg, PhD; Josten, Christoph, MD§; Böhme, Jörg, MD§; Spanel-Borowski, Katharina, MD*

doi: 10.1097/BRS.0b013e3181b7c675

Study Design. The ligaments of the human sacroiliac joint (SIJ) were investigated morphometrically.

Objective. A macroscopical study was performed to measure the anterior sacroiliac ligament (ASL), the interosseous sacroiliac ligament (ISL), and the posterior sacroiliac ligament (PSL), applying different methods of ligament visualization.

Summary of Background Data. Little is known about the SIJ ligaments, especially about the ISL. Pelvic computer simulations neglect these ligaments due to the lack of information. Computer simulations of the SIJ ligaments may help to improve the clinical outcome of SIJ operations.

Methods. Seven-Tesla MR images, CT images, and corresponding thin slice plastinates of the SIJ of 1 male and 1 female specimen were obtained. Serial sections of the SIJ of 32 frozen specimens (13 males, 19 females) were generated to gather measurements of the SIJ ligaments.

Results. By means of the MR images and the plastinates, a virtual reconstruction of the SIJ ligaments was accomplished. Parallelepipeds were attributed to the cranial, middle, and caudal parts of all SIJ ligaments. This allowed precise measurements and statistical comparison including positional relationships. The ISL volumes and origin surfaces were the largest. Statistically, the ASL and PSL parameters were larger in males, while the ISL parameters were larger in females. The height of the cranial ASL part showed large negative correlations in spite of positive correlations of the other heights.

Conclusion. The combined use of high-resolution MRI and thin slice plastination allows precise reconstructions of the SIJ ligaments. With these techniques, the ligaments can be visualized in situ and described morphometrically if based on substantive data. The SIJ ligaments are gender-dependent. This has to be taken into account for pelvic computer simulations.

The ligaments of the sacroiliac joint were investigated, using 7-T MRI and thin slice plastination of 2 pelves as well as frozen sections of 32 specimens. A virtual reconstruction was accomplished and geometric figures have been created for each of the structures. Gender-dependent parameters were obtained for the sacroiliac joint ligaments.

From the *Institute of Anatomy, University of Leipzig, Leipzig, Germany; †Leipzig University of Applied Sciences (HTWK), Leipzig, Germany; ‡Leibniz Institute for Neurobiology, Magdeburg, Germany; and §Department of Trauma and Reconstructive Surgery, University of Leipzig, Leipzig, Germany.

Acknowledgment date: February 20, 2009. Acceptance date: May 18, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

HS and NH contributed equally to the manuscript.

Address correspondence and reprint request to Hanno Steinke, Liebigstraße 13, D-04103 Leipzig, Germany; E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.