Ethnic Differences in Western and Asian Sacroiliac Joint Anatomy for Surgical Planning of Minimally Invasive Sacroiliac Joint Fusion

Christopher Wu, Yu Cheng Liu, Hiroaki Koga, Ching Yu Lee, Po Yao Wang, Daniel Cher, W. Carlton Reckling, Tsung Jen Huang, Meng Huang Wu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


Pain originating in the sacroiliac joint (SIJ) is a contributor to chronic lower back pain. Studies on minimally invasive SIJ fusion for chronic pain have been performed in Western populations. Given the shorter stature of Asian populations compared with Western populations, questions can be raised regarding the suitability of the procedure in Asian patients. This study investigated the differences in 12 measurements of sacral and SIJ anatomy between two ethnic populations by analyzing computed tomography scans of 86 patients with SIJ pain. Univariate linear regression was performed to evaluate the correlations of body height with sacral and SIJ measurements. Multivariate regression analysis was used to evaluate systematic differences across populations. Most sacral and SIJ measurements were moderately correlated with body height. The anterior–posterior thickness of the sacral ala at the level of the S1 body was significantly smaller in the Asian patients compared with the Western patients. Most measurements were above standard surgical thresholds for safe transiliac placement of devices (1026 of 1032, 99.4%); all the measurements below these surgical thresholds were found in the anterior–posterior distance of the sacral ala at the S2 foramen level. Overall, safe placement of implants was allowed in 84 of 86 (97.7%) patients. Sacral and SIJ anatomy relevant to transiliac device placement is variable and correlates moderately with body height, and the cross-ethnic variations are not significant. Our findings raise a few concerns regarding sacral and SIJ anatomy variation that would prevent safe placement of fusion implants in Asian patients. However, considering the observed S2-related anatomic variation that could affect placement strategy, sacral and SIJ anatomy should still be preoperatively evaluated.

Original languageEnglish
Article number883
Issue number5
StatePublished - 25 02 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.


  • anatomy
  • ethnic differences
  • sacroiliac joint
  • transiliac sacroiliac joint fusion


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