ヒト仙腸関節における三次元形態解析：腸骨耳状面の変性変化における形態の影響について

The sacroiliac joint (SIJ) is responsible for weight transmission between the spine and lower extremity. However, details of the structure and function of the SIJ remain unclear. In a previous study, we devised a method of quantitatively evaluating the level of degeneration of the SIJ using an age estimation procedure for the auricular surface of the ilium. Our results in that study suggested that the degree of degeneration of the joint surface may be associated with the morphology of the auricular surface of the ilium. In that study, however, the morphology of the auricular surface of the ilium was simplified for analysis, meaning that more detailed investigations were required in future. In the present study, we focused on individual differences in the shape of SIJ and carried out three‐dimensional quantitative evaluation of the morphology of the auricular surface of the ilium to ascertain its association with joint degeneration. We produced three‐dimensional images of the right auricular surfaces of the ilium of 100 modern Japanese men (age 19–83), and obtained the three‐dimensional rectangular coordinates of 11 defined measurement points. We then calculated 16 parameters indicating the morphological characteristics of the auricular surfaces of the ilium from the three‐dimensional rectangular coordinates of these measurement points, and used these to perform principal component analysis to investigate trends in the morphology of the auricular surface of the ilium. We found that the morphology of the auricular surface of the ilium could be characterized in terms of (i) size, (ii) concavity of the posterior border and (iii) amount of undulation. An investigation of the correlation between these parameters and age suggested that the amount of undulation of the auricular surface of the ilium tends to diminish with advancing age. In an investigation of the association between morphology of the auricular surface of the ilium and degeneration of the articular surface when the subjects were divided into a high‐degeneration group (n = 55) and a low‐degeneration group (n = 45) and the 16 parameters were compared, there was a significant difference in the amount of undulation of the auricular surface of the ilium. In an investigation limited to older subjects aged ≥ 60 (n = 47) at the time of death, there were significant differences between the high‐degeneration group (n = 27) and low‐degeneration group (n = 20) in terms not only of the parameters indicating the amount of undulation of the auricular surface of the ilium but also of those indicating the amount of the concavity of the posterior border. These results suggested that the amount of undulation of the auricular surface of the ilium may affect the degree of degeneration of the articular surface. In addition, in older subjects, the degree of concavity of the posterior border of the SIJ may also affect the degree of degeneration of the articular surface. It is thus likely that differences in the morphology of the auricular surface of the ilium may affect degenerative changes in the SIJ.長崎大学学位論文 学位記番号:博(医歯薬)甲第1032号 学位授与年月日:平成30年3月20