Computed tomographic findings in patients with persistent sacroiliac pain after posterior iliac graft harvesting

Abstract

Study design: A retrospective study of 24 sacroiliac joint computed tomographic (CT) scans of patients with persistent donor site pain.

Objective: To illustrate the computed tomographic findings of sacroiliac joints in patients who underwent posterior iliac bone graft harvesting with subsequent persistent donor site pain.

Summary of background data: In a previous study the posterior iliac bone harvesting site was divided into three zones. Zone 1 carried no risk of violation of the synovial part of the sacroiliac joint. In Zones 2 and 3 there was a potential risk of violation to the synovial part of the sacroiliac joint. There is no study in the literature on the effect of violating the different parts of the sacroiliac joint during posterior iliac bone graft harvesting.

Methods: Computed tomographic scans of the sacroiliac joints of 22 patients with persistent pain in 24 sacroiliac joints after posterior iliac bone graft harvesting were retrospectively reviewed.

Results: Of the 16 sacroiliac joints with evidence of disruption of the inner table at the ligamentous part, 10 showed mild degenerative changes, and 6 showed moderate changes. Three joints with evidence of disruption of the inner table at the synovial part showed severe degenerative changes. Five joints with no evidence of inner table disruption did not show degenerative changes.

Conclusion: There is a high prevalence of inner table disruption in patients with persistent sacroiliac joint pain after posterior iliac bone graft harvesting. The computed tomographic scan showed that involvement of the synovial part caused more severe degenerative changes than involvement of the ligamentous part.