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.	冯智英, 郑拥军, 许继军, 等. 骶髂关节痛诊疗中国专家共识. 中国疼痛医学杂志, 2021, 27(2): 87-93.
3.	张少群, 李乃奇, 祁冀, 等. 基于文献计量学分析骶髂关节错位的历史沿革. 中国组织工程研究, 2018, 22(27): 4316-4321.
4.	王丽. 骶髂关节错位的 FST 综合手段方案设计与应用. 聊城: 聊城大学, 2020.
5.	孙慧民. 手法治疗骶髂关节后错位疗效观察. 中国中医药信息杂志, 2012, 19(6): 66-67.
6.	李强, 樊效鸿, 熊福生. 清宫正骨弯腰挺立手法治疗骶髂关节紊乱的临床疗效观察. 现代养生, 2024, 24(13): 978-981.
7.	张梦娇, 高翔, 张奕奕, 等. 石氏伤科正骨理筋手法治疗骶髂关节紊乱症的临床研究. 内蒙古中医药, 2023, 42(4): 90-91.
8.	陈礼彬, 尹秋华, 范志勇. 林氏正骨手法治疗骶髂关节紊乱的临床疗效比较研究. 当代医学, 2021, 27(19): 144-146.
9.	林东, 张坤木, 林斌强, 等. “筋骨并重”理论在骶髂关节错位中的应用探讨. 亚太传统医药, 2023, 19(2): 233-236.
10.	郑晓琴, 张坤木, 翁财, 等. 基于脊柱-骨盆平衡探讨屈髋屈膝按压法治疗骶髂关节错位验案一则. 按摩与康复医学, 2022, 13(9): 20-23.
11.	郑伟康, 吴以诚. 国医大师李业甫“筋骨并举”推拿治疗骶髂关节紊乱经验撷菁. 中医药临床杂志, 2023, 35(5): 914-917.
12.	诸波, 范炳华, 王鹏, 等. 蛙式扳法治疗骶髂关节源性下腰痛的临床疗效观察. 中华中医药学刊, 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.	张少群, 任茹霞, 陈奕历, 等. 骶髂关节周围各韧带对骶髂关节稳定性的影响. 医用生物力学, 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.	谌祖江, 杨先文, 向孝兵, 等. 屈髋屈膝按压法作用于骨盆的三维有限元分析. 医用生物力学, 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, 庄哲, 吴建丽, 等. 髂后上棘微调矫正法治疗骶髂关节后下错位的临床疗效观察. 中医药学报, 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.	李长辉, 汤丽珠, 林斌强, 等. 整复手法对骶髂关节错位骨盆及下肢生物力学的影响. 中医康复, 2024, 1(4): 18-21, 25.
34.	范世东, 李向坦, 阎晓霞. 点穴理筋调整手法配合筋针疗法治疗髌骨软化症临床研究. 中医药临床杂志, 2022, 34(4): 743-746.
35.	周一甫, 徐通, 于峰, 等. 针刺结合理筋手法治疗神经根型颈椎病临床研究. 光明中医, 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, 仲霄鹏, 等. 腰椎退变黄韧带的生物力学测定. 中国脊柱脊髓杂志, 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. 冯智英, 郑拥军, 许继军, 等. 骶髂关节痛诊疗中国专家共识. 中国疼痛医学杂志, 2021, 27(2): 87-93.
3. 张少群, 李乃奇, 祁冀, 等. 基于文献计量学分析骶髂关节错位的历史沿革. 中国组织工程研究, 2018, 22(27): 4316-4321.
4. 王丽. 骶髂关节错位的 FST 综合手段方案设计与应用. 聊城: 聊城大学, 2020.
5. 孙慧民. 手法治疗骶髂关节后错位疗效观察. 中国中医药信息杂志, 2012, 19(6): 66-67.
6. 李强, 樊效鸿, 熊福生. 清宫正骨弯腰挺立手法治疗骶髂关节紊乱的临床疗效观察. 现代养生, 2024, 24(13): 978-981.
7. 张梦娇, 高翔, 张奕奕, 等. 石氏伤科正骨理筋手法治疗骶髂关节紊乱症的临床研究. 内蒙古中医药, 2023, 42(4): 90-91.
8. 陈礼彬, 尹秋华, 范志勇. 林氏正骨手法治疗骶髂关节紊乱的临床疗效比较研究. 当代医学, 2021, 27(19): 144-146.
9. 林东, 张坤木, 林斌强, 等. “筋骨并重”理论在骶髂关节错位中的应用探讨. 亚太传统医药, 2023, 19(2): 233-236.
10. 郑晓琴, 张坤木, 翁财, 等. 基于脊柱-骨盆平衡探讨屈髋屈膝按压法治疗骶髂关节错位验案一则. 按摩与康复医学, 2022, 13(9): 20-23.
11. 郑伟康, 吴以诚. 国医大师李业甫“筋骨并举”推拿治疗骶髂关节紊乱经验撷菁. 中医药临床杂志, 2023, 35(5): 914-917.
12. 诸波, 范炳华, 王鹏, 等. 蛙式扳法治疗骶髂关节源性下腰痛的临床疗效观察. 中华中医药学刊, 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. 张少群, 任茹霞, 陈奕历, 等. 骶髂关节周围各韧带对骶髂关节稳定性的影响. 医用生物力学, 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. 谌祖江, 杨先文, 向孝兵, 等. 屈髋屈膝按压法作用于骨盆的三维有限元分析. 医用生物力学, 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, 庄哲, 吴建丽, 等. 髂后上棘微调矫正法治疗骶髂关节后下错位的临床疗效观察. 中医药学报, 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. 李长辉, 汤丽珠, 林斌强, 等. 整复手法对骶髂关节错位骨盆及下肢生物力学的影响. 中医康复, 2024, 1(4): 18-21, 25.
34. 范世东, 李向坦, 阎晓霞. 点穴理筋调整手法配合筋针疗法治疗髌骨软化症临床研究. 中医药临床杂志, 2022, 34(4): 743-746.
35. 周一甫, 徐通, 于峰, 等. 针刺结合理筋手法治疗神经根型颈椎病临床研究. 光明中医, 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, 仲霄鹏, 等. 腰椎退变黄韧带的生物力学测定. 中国脊柱脊髓杂志, 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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