Objective To study the anatomical characteristics of posterior superior iliac spine and explore its clinical significance. Methods Two hundred and eighty dry hip specimens of humans were selected. The posterior superior iliac spine was point A, the anterior superior iliac spine was point B, the ischial tuberosity was point C, the highest point of the iliac spine was point D, the pubic tuberosity was point E, and the midpoint of the posterior edge of the articular surface was point F. The width of point A of the posterior superior iliac spine was W0, and the thickness of point A was H0. The maximum width of the posterior part of the iliac crest was Wmax, and the distance from point A to the posterior part of the iliac crest was D0. The width of the iliac crest was measured at 0.5 cm, 1.0 cm, 1.5 cm, and 2.0 cm from point A, which were recorded as W1, W2, W3, W4. The part of the iliac crest was taken as point G and the width of point G was denoted as W5. The lengths of AB, AC, AD, AE, AF, AG, and CD were measured, respectively. Results The morphology of the posterior superior iliac spine was roughly divided into the following 4 types: type I "V" (107 cases, accounting for 38.2%), type II "U" (121 cases, accounting for 43.2%), type III "W" (31 cases, accounting for 11.1%), type IV "Proliferative" (21 cases, accounting for 7.5%). The AB length of type Ⅰ was significantly shorter than that of type Ⅲ and Ⅳ, the AF distance of type Ⅰ was significantly shorter than that of type Ⅱ and Ⅲ. W0, W1 and H0 of type Ⅰ were significantly smaller than that of type Ⅱ, Ⅲ, and Ⅳ, and W0 of type Ⅲ was greater than that of type I, type II and type IV, all were statistically significant (P<0.05). Conclusions There are 4 morphological variations of the posterior superior iliac spine, with a "U" shape as the main one, which has of certain clinical implication.
Key words
Posterior superior iliac spine; /
/
Anatomy; /
/
Clinical significance
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 钟世镇. 系统解剖学[M]. 北京: 高等教育出版社, 2003: 28-29.
[2] McGaugh JM, Brismée JM, Dedrick GS, et al. Comparing the anatomical consistency of the posterior superior iliac spine to the iliac crest as reference landmarks for the lumbopelvic spine: a retrospective radiological study[J]. Clin Anat, 2007, 20(7): 819-825. DOI: 10.1002/ca.20531.
[3] Murakami E, Kurosawa D, Aizawa T. Treatment strategy for sacroiliac joint-related pain at or around the posterior superior iliac spine[J]. Clin Neurol Neurosurg, 2018, 165(2): 43-46. DOI: 10.1016/j.clineuro.2017.12.017.
[4] Cooperstein R, Hickey M. The reliability of palpating the posterior superior iliac spine: a systematic review[J]. J Can Chiropr Assoc, 2016, 60(1): 36-46. PMID: 27069265.
[5] 官大威. 法医学辞典[M]. 北京: 化学工业出版社, 2009: 101.
[6] Bonczarowska JH, Bonicelli A, Papadomanolakis A, et al. The posterior portion of the ilium as a sex indicator: a validation study[J]. Forensic Sci Int, 2019,294(1): 216.e1-216.e6. DOI: 10.1016/j.forsciint. 2018. 10.031.
[7] Rmoutilová R, Dupej J, Velemínská J, et al. Geometric morphometric and traditional methods for sex assessment using the posterior ilium[J]. Leg Med (Tokyo),2017,26(5):52-61. DOI: 10.1016/j.legalmed. 2017. 03. 004.
[8] Xu R, Ebraheim NA, Yeasting RA, et al. Anatomic considerations for posterior iliac bone harvesting[J]. Spine (Phila Pa 1976), 1996, 21(9): 1017-1020. DOI: 10.1097/00007632-199605010-00004.
[9] Ebraheim NA, Elgafy H, Xu R. Bone-graft harvesting from iliac and fibular donor sites: techniques and complications[J]. J Am Acad Orthop Surg, 2001, 9(3): 210-218. DOI: 10.5435/00124635-200105000-00007.
[10]吴垠. 如何选择合适的骨髓穿刺部位[J]. 中国全科医学, 2013, 16(12): 1443-1444. DOI: 10.3969/j. ssn.1007-9572.2013.04.115.
[11] Yi KH, Lee HJ, Lee JH, et al. Effective botulinum neurotoxin injection in treating iliopsoas spasticity[J]. Clin Anat, 2021, 34(3): 431-436. DOI: 10.1002/ca.23670.
[12] Lin JD, Tan LA, Wei C, et al. The posterior superior iliac spine and sacral laminar slope: key anatomical landmarks for freehand S2-alar-iliac screw placement[J]. Neurosurg Spine, 2018, 29(4): 429-434. DOI: 10.3171/2018.3.SPINE171374.
[13] Kim HW, Ko YJ, Rhee WI, et al. Interexaminer reliability and accuracy of posterior superior iliac spine and iliac crest palpation for spinal level estimations[J]. J Manipulative Physiol Ther, 2007, 30(5): 386-389. DOI: 10.1016/j.jmpt.2007.04.005.
[14] Srivastava S, Kumar KUD, Mittal H, et al. Short-term effect of muscle energy technique and mechanical diagnosis and therapy in sacroiliac joint dysfunction: a pilot randomized clinical trial[J]. Bodyw Mov Ther, 2020, 24(3): 63-70. DOI: 10.1016/j.jbmt.2020.02.017.
[15] Werner CM, Hoch A, Gautier L, et al. Distraction test of the posterior superior iliac spine (PSIS) in the diagnosis of sacroiliac joint arthropathy[J]. BMC Surg, 2013, 13: 52. DOI: 10.1186/1471-2482-13-52.
[16]樊春洲. 骶髂关节错位的诊断与治疗[J]. 黑龙江医药, 1980, 11(3): 7-9.
[17]王廷臣. 骶髂关节错位的理论思考[J]. 中国组织工程研究与临床康复,2008,12(11):2161-2163.DOI:10.3321/j.issn:673-8225.2008.11.042.
[18] Edge-Hughes L. Hip and sacroiliac disease: selected disorders and their management with physical therapy[J]. Clin Tech Small Anim Pract, 2007, 22(4): 183-194. DOI: 10.1053/j.ctsap.2007.09.007.
[19]唐承杰, 陈经勇, 陈如见, 等. 自体髂后上棘骨移植在全髋关节置换术后髋臼松动翻修术中的应用[J]. 四川医学, 2010, 31(10): 1495-1496, DOI: 10.3969/j.issn.1004-0501.2010.10.040.
[20]Nishi K, Tsurumoto T, Okamoto K, et al. Three-dimensional morphological analysis of the human sacroiliac joint: influences on the degenerative changes of the auricular surfaces[J]. J Anat, 2018, 232(2): 238-249. DOI: 10.1111/joa.12765.
PDF(3716 KB)
