Effect of sacrum-stabilized iliac traction on the stress and displacement of sacroiliac joint and iliolumbar ligament_Journal of Biomedical Engineering

Authors：

SHI Shihao ¹ , XU Shuyan ¹ , ZHOU Xuanyu ¹ , WANG Yuting ¹ , HAN Chengxun ¹ , CHEN Meicheng ¹ ,  QI Ji ^1,2,3,4,5 ,  WANG Haizhou ^1,3

1. The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, P. R. China;
2. Guangdong Provincial Laboratory of Traditional Chinese Medicine, Zhuhai, Guangdong 519060, P. R. China;
3. The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, P. R. China;
4. Orthopaedic Biomechanics Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, P. R. China;
5. State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou 510120, P. R. China;

Corresponding?author：

QI Ji, Email: 516774578@qq.com; WANG Haizhou, Email: bigbigwolf1@163.com

Keywords：

Sacrum-stabilized iliac traction; Sacroiliac joint; Iliolumbar ligament; Finite element analysis; Biomechanics

DOI：

10.7507/1001-5515.202509007

Video：

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To investigate the biomechanical effects of sacrum-stabilized iliac traction manipulation on stress and displacement responses in the sacroiliac joint (SIJ) and iliolumbar ligament, a three-dimensional finite element model of the lumbar-pelvic complex was developed based on detailed anatomical structure. First, the articular cartilage and iliolumbar ligament were carefully reconstructed according to realistic human anatomy, with special emphasis placed on creating a solid-element representation of the ligament to accurately simulate its mechanical behavior. After model validation, simulations were performed under both physiological and manipulative loading conditions to quantitatively compare the stress, displacement, and range of motion of the SIJ and iliolumbar ligament. The results showed that under manipulative loading, the SIJ exhibited greater articular surface stress (11.057 MPa), displacement (0.209 mm), and range of motion (0.21°) than under physiological loading, although all values remained within the physiological range. The overall displacement of the iliolumbar ligament during manipulation was also found to be twice that of the joint surface. In conclusion, this study demonstrates that the therapeutic mechanism of sacrum-stabilized iliac traction manipulation primarily relies on stretching and releasing soft tissues and adjusting stress distribution between the joint surface and the iliolumbar ligament, rather than on high-amplitude joint thrust. These findings provide biomechanical support for the clinical application of this technique.

Citation： SHI Shihao, XU Shuyan, ZHOU Xuanyu, WANG Yuting, HAN Chengxun, CHEN Meicheng, QI Ji, WANG Haizhou. Effect of sacrum-stabilized iliac traction on the stress and displacement of sacroiliac joint and iliolumbar ligament. Journal of Biomedical Engineering, 2026, 43(1): 154-160. doi: 10.7507/1001-5515.202509007 Copy

1.	Buchanan P, Vodapally S, Lee D W, et al. Successful diagnosis of sacroiliac joint dysfunction. J Pain Res, 2021, 14: 3135-3143.
2.	馮智英, 鄭擁軍, 許繼軍, 等. 骶髂關節痛診療中國專家共識. 中國疼痛醫學雜志, 2021, 27(2): 87-93.
3.	張少群, 李乃奇, 祁冀, 等. 基于文獻計量學分析骶髂關節錯位的歷史沿革. 中國組織工程研究, 2018, 22(27): 4316-4321.
4.	王麗. 骶髂關節錯位的 FST 綜合手段方案設計與應用. 聊城: 聊城大學, 2020.
5.	孫慧民. 手法治療骶髂關節后錯位療效觀察. 中國中醫藥信息雜志, 2012, 19(6): 66-67.
6.	李強, 樊效鴻, 熊福生. 清宮正骨彎腰挺立手法治療骶髂關節紊亂的臨床療效觀察. 現代養生, 2024, 24(13): 978-981.
7.	張夢嬌, 高翔, 張奕奕, 等. 石氏傷科正骨理筋手法治療骶髂關節紊亂癥的臨床研究. 內蒙古中醫藥, 2023, 42(4): 90-91.
8.	陳禮彬, 尹秋華, 范志勇. 林氏正骨手法治療骶髂關節紊亂的臨床療效比較研究. 當代醫學, 2021, 27(19): 144-146.
9.	林東, 張坤木, 林斌強, 等. “筋骨并重”理論在骶髂關節錯位中的應用探討. 亞太傳統醫藥, 2023, 19(2): 233-236.
10.	鄭曉琴, 張坤木, 翁財, 等. 基于脊柱-骨盆平衡探討屈髖屈膝按壓法治療骶髂關節錯位驗案一則. 按摩與康復醫學, 2022, 13(9): 20-23.
11.	鄭偉康, 吳以誠. 國醫大師李業甫“筋骨并舉”推拿治療骶髂關節紊亂經驗擷菁. 中醫藥臨床雜志, 2023, 35(5): 914-917.
12.	諸波, 范炳華, 王鵬, 等. 蛙式扳法治療骶髂關節源性下腰痛的臨床療效觀察. 中華中醫藥學刊, 2012, 30(7): 1607-1609.
13.	Waldman L E, Maluli I, Moon C N, et al. Sacroiliac joint dysfunction: anatomy, pathophysiology, differential diagnosis, and treatment approaches. Skeletal Radiol, 2025, 54(6): 1195-1213.
14.	張少群, 任茹霞, 陳奕歷, 等. 骶髂關節周圍各韌帶對骶髂關節穩定性的影響. 醫用生物力學, 2019, 34(5): 500-506.
15.	Li J, Li Y, Ping R, et al. Biomechanical analysis of sacroiliac joint motion following oblique-pulling manipulation with or without pubic symphysis injury. Front Bioeng Biotechnol, 2022, 10: 960090.
16.	Momeni S N, Fatemi A, Goel V K, et al. On the use of biaxial properties in modeling annulus as a Holzapfel-Gasser-Ogden material. Front Bioeng Biotechnol, 2015, 3: 69.
17.	Lindsey D P, Kiapour A, Yerby S A, et al. Sacroiliac joint fusion minimally affects adjacent lumbar segment motion: A finite element study. Int J Spine Surg, 2015, 9: 64.
18.	諶祖江, 楊先文, 向孝兵, 等. 屈髖屈膝按壓法作用于骨盆的三維有限元分析. 醫用生物力學, 2015, 30(3): 233-237.
19.	Bailly N, Diotalevi L, Beauséjour M H, et al. Numerical investigation of the relative effect of disc bulging and ligamentum flavum hypertrophy on the mechanism of central cord syndrome. Clinical Biomechanics, 2020, 74: 58-65.
20.	Peng Y, Zheng Z, Wang W, et al. Relationship between the location of ligamentum flavum hypertrophy and its stress in finite element analysis. Orthopaedic Surgery, 2020, 12(3): 974-982.
21.	El-Rich M, Arnoux P J, Wagnac E, et al. Finite element investigation of the loading rate effect on the spinal load-sharing changes under impact conditions. J Biomech, 2009, 42(9): 1252-1262.
22.	John J D, Saravana K G, Yoganandan N. Cervical spine morphology and ligament property variations: A finite element study of their influence on sagittal bending characteristics. J Biomech, 2019, 85: 18-26.
23.	Lindsey D, Perez-Orribo L, Rodriguez-Martinez N, et al. Evaluation of a minimally invasive procedure for sacroiliac joint fusion–an in vitro biomechanical analysis of initial and cycled properties. Med Devices (Auckl), 2014, 7: 131-137.
24.	Cano-Luis P, Giráldez-Sanchez M A, Martínez-Reina J, et al. Biomechanical analysis of a new minimally invasive system for osteosynthesis of pubis symphysis disruption. Injury, 2012, 43: S20-S27.
25.	王永亮, 莊哲, 吳建麗, 等. 髂后上棘微調矯正法治療骶髂關節后下錯位的臨床療效觀察. 中醫藥學報, 2022, 50(1): 80-85.
26.	Sturessonm B, Selvik G, Uden A. Movements of the sacroiliac joints. A roentgen stereophotogrammetric analysis. Spine, 1989, 14(2): 162-165.
27.	Smidt G L, McQuade K, Wei S H. Sacroiliac kinematics for reciprocal straddle positions. Spine, 1995, 20(9): 1047-1054.
28.	Walker J M. The sacroiliac joint: a critical review. Phys Ther, 1992, 72(12): 903-916.
29.	Chen Z J, Yang X W, Xiang X B. 3D finite element anaIysis on pelvic under compressing manipulation by flexing hip and knee. J Med Biomech, 2015, 30(3): 233-237.
30.	Tullberg T, Blomberg S, Branth B, et al. Manipulation does not alter the position of the sacroiliac joint. A roentgen stereophotogrammetric analysis. Spine, 1998, 23(10): 1124-1128.
31.	Ivanov A A, Kiapour A, Ebraheim N A, et al. Lumbar fusion leads to increases in angular motion and stress across sacroiliac joint: a finite element study. Spine, 2009, 34(5): E162-E169.
32.	Xu Z, Feng Z, Zhang Z, et al. Manipulations of oblique pulling affect sacroiliac joint displacements and ligament strains: A finite element analysis. J Healthc Eng, 2023, 2023: 2840421.
33.	李長輝, 湯麗珠, 林斌強, 等. 整復手法對骶髂關節錯位骨盆及下肢生物力學的影響. 中醫康復, 2024, 1(4): 18-21, 25.
34.	范世東, 李向坦, 閻曉霞. 點穴理筋調整手法配合筋針療法治療髕骨軟化癥臨床研究. 中醫藥臨床雜志, 2022, 34(4): 743-746.
35.	周一甫, 徐通, 于峰, 等. 針刺結合理筋手法治療神經根型頸椎病臨床研究. 光明中醫, 2023, 38(14): 2784-2787.
36.	Barbe M F, Panibatla S T, Harris M Y, et al. Manual therapy with rest as a treatment for established inflammation and fibrosis in a rat model of repetitive strain injury. Front Physiol, 2021, 12: 755923.
37.	Szadek K M, Hoogland P V, Zuurmond W W, et al. Possible nociceptive structures in the sacroiliac joint cartilage: An immunohistochemical study. Clin Anatomy, 2010, 23(2): 192-198.
38.	上官磊, 樊星, 仲霄鵬, 等. 腰椎退變黃韌帶的生物力學測定. 中國脊柱脊髓雜志, 2009, 19(10): 749-752.

1. Buchanan P, Vodapally S, Lee D W, et al. Successful diagnosis of sacroiliac joint dysfunction. J Pain Res, 2021, 14: 3135-3143.
2. 馮智英, 鄭擁軍, 許繼軍, 等. 骶髂關節痛診療中國專家共識. 中國疼痛醫學雜志, 2021, 27(2): 87-93.
3. 張少群, 李乃奇, 祁冀, 等. 基于文獻計量學分析骶髂關節錯位的歷史沿革. 中國組織工程研究, 2018, 22(27): 4316-4321.
4. 王麗. 骶髂關節錯位的 FST 綜合手段方案設計與應用. 聊城: 聊城大學, 2020.
5. 孫慧民. 手法治療骶髂關節后錯位療效觀察. 中國中醫藥信息雜志, 2012, 19(6): 66-67.
6. 李強, 樊效鴻, 熊福生. 清宮正骨彎腰挺立手法治療骶髂關節紊亂的臨床療效觀察. 現代養生, 2024, 24(13): 978-981.
7. 張夢嬌, 高翔, 張奕奕, 等. 石氏傷科正骨理筋手法治療骶髂關節紊亂癥的臨床研究. 內蒙古中醫藥, 2023, 42(4): 90-91.
8. 陳禮彬, 尹秋華, 范志勇. 林氏正骨手法治療骶髂關節紊亂的臨床療效比較研究. 當代醫學, 2021, 27(19): 144-146.
9. 林東, 張坤木, 林斌強, 等. “筋骨并重”理論在骶髂關節錯位中的應用探討. 亞太傳統醫藥, 2023, 19(2): 233-236.
10. 鄭曉琴, 張坤木, 翁財, 等. 基于脊柱-骨盆平衡探討屈髖屈膝按壓法治療骶髂關節錯位驗案一則. 按摩與康復醫學, 2022, 13(9): 20-23.
11. 鄭偉康, 吳以誠. 國醫大師李業甫“筋骨并舉”推拿治療骶髂關節紊亂經驗擷菁. 中醫藥臨床雜志, 2023, 35(5): 914-917.
12. 諸波, 范炳華, 王鵬, 等. 蛙式扳法治療骶髂關節源性下腰痛的臨床療效觀察. 中華中醫藥學刊, 2012, 30(7): 1607-1609.
13. Waldman L E, Maluli I, Moon C N, et al. Sacroiliac joint dysfunction: anatomy, pathophysiology, differential diagnosis, and treatment approaches. Skeletal Radiol, 2025, 54(6): 1195-1213.
14. 張少群, 任茹霞, 陳奕歷, 等. 骶髂關節周圍各韌帶對骶髂關節穩定性的影響. 醫用生物力學, 2019, 34(5): 500-506.
15. Li J, Li Y, Ping R, et al. Biomechanical analysis of sacroiliac joint motion following oblique-pulling manipulation with or without pubic symphysis injury. Front Bioeng Biotechnol, 2022, 10: 960090.
16. Momeni S N, Fatemi A, Goel V K, et al. On the use of biaxial properties in modeling annulus as a Holzapfel-Gasser-Ogden material. Front Bioeng Biotechnol, 2015, 3: 69.
17. Lindsey D P, Kiapour A, Yerby S A, et al. Sacroiliac joint fusion minimally affects adjacent lumbar segment motion: A finite element study. Int J Spine Surg, 2015, 9: 64.
18. 諶祖江, 楊先文, 向孝兵, 等. 屈髖屈膝按壓法作用于骨盆的三維有限元分析. 醫用生物力學, 2015, 30(3): 233-237.
19. Bailly N, Diotalevi L, Beauséjour M H, et al. Numerical investigation of the relative effect of disc bulging and ligamentum flavum hypertrophy on the mechanism of central cord syndrome. Clinical Biomechanics, 2020, 74: 58-65.
20. Peng Y, Zheng Z, Wang W, et al. Relationship between the location of ligamentum flavum hypertrophy and its stress in finite element analysis. Orthopaedic Surgery, 2020, 12(3): 974-982.
21. El-Rich M, Arnoux P J, Wagnac E, et al. Finite element investigation of the loading rate effect on the spinal load-sharing changes under impact conditions. J Biomech, 2009, 42(9): 1252-1262.
22. John J D, Saravana K G, Yoganandan N. Cervical spine morphology and ligament property variations: A finite element study of their influence on sagittal bending characteristics. J Biomech, 2019, 85: 18-26.
23. Lindsey D, Perez-Orribo L, Rodriguez-Martinez N, et al. Evaluation of a minimally invasive procedure for sacroiliac joint fusion–an in vitro biomechanical analysis of initial and cycled properties. Med Devices (Auckl), 2014, 7: 131-137.
24. Cano-Luis P, Giráldez-Sanchez M A, Martínez-Reina J, et al. Biomechanical analysis of a new minimally invasive system for osteosynthesis of pubis symphysis disruption. Injury, 2012, 43: S20-S27.
25. 王永亮, 莊哲, 吳建麗, 等. 髂后上棘微調矯正法治療骶髂關節后下錯位的臨床療效觀察. 中醫藥學報, 2022, 50(1): 80-85.
26. Sturessonm B, Selvik G, Uden A. Movements of the sacroiliac joints. A roentgen stereophotogrammetric analysis. Spine, 1989, 14(2): 162-165.
27. Smidt G L, McQuade K, Wei S H. Sacroiliac kinematics for reciprocal straddle positions. Spine, 1995, 20(9): 1047-1054.
28. Walker J M. The sacroiliac joint: a critical review. Phys Ther, 1992, 72(12): 903-916.
29. Chen Z J, Yang X W, Xiang X B. 3D finite element anaIysis on pelvic under compressing manipulation by flexing hip and knee. J Med Biomech, 2015, 30(3): 233-237.
30. Tullberg T, Blomberg S, Branth B, et al. Manipulation does not alter the position of the sacroiliac joint. A roentgen stereophotogrammetric analysis. Spine, 1998, 23(10): 1124-1128.
31. Ivanov A A, Kiapour A, Ebraheim N A, et al. Lumbar fusion leads to increases in angular motion and stress across sacroiliac joint: a finite element study. Spine, 2009, 34(5): E162-E169.
32. Xu Z, Feng Z, Zhang Z, et al. Manipulations of oblique pulling affect sacroiliac joint displacements and ligament strains: A finite element analysis. J Healthc Eng, 2023, 2023: 2840421.
33. 李長輝, 湯麗珠, 林斌強, 等. 整復手法對骶髂關節錯位骨盆及下肢生物力學的影響. 中醫康復, 2024, 1(4): 18-21, 25.
34. 范世東, 李向坦, 閻曉霞. 點穴理筋調整手法配合筋針療法治療髕骨軟化癥臨床研究. 中醫藥臨床雜志, 2022, 34(4): 743-746.
35. 周一甫, 徐通, 于峰, 等. 針刺結合理筋手法治療神經根型頸椎病臨床研究. 光明中醫, 2023, 38(14): 2784-2787.
36. Barbe M F, Panibatla S T, Harris M Y, et al. Manual therapy with rest as a treatment for established inflammation and fibrosis in a rat model of repetitive strain injury. Front Physiol, 2021, 12: 755923.
37. Szadek K M, Hoogland P V, Zuurmond W W, et al. Possible nociceptive structures in the sacroiliac joint cartilage: An immunohistochemical study. Clin Anatomy, 2010, 23(2): 192-198.
38. 上官磊, 樊星, 仲霄鵬, 等. 腰椎退變黃韌帶的生物力學測定. 中國脊柱脊髓雜志, 2009, 19(10): 749-752.

Journal of Biomedical Engineering

Effect of sacrum-stabilized iliac traction on the stress and displacement of sacroiliac joint and iliolumbar ligament

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