Interaction effect of spino-pelvic parameters and progress of L5 isthmic spondylolisthesis

doi:10.3969/j.issn.2095-4344.0357

Abstract

Abstract:

BACKGROUND: Progress of L₅ isthmic spondylolisthesis determined based on the spino-pelvic sagittal parameters has been drawn much attention, but has not been confirmed. Their interactions have not been summarized.

OBJECTIVE: To investigate the correlations of spino-pelvic parameters and degeneration of L₅/S₁ intervertebral disc with spondylolisthesis rate in L₅ isthmic spondylolisthesis, and to explore the interaction between spino-pelvic parameters and progress of spondylolisthesis.

METHODS: Eighty-three patients with L₅ isthmic spondylolisthesis from September 2013 to September 2017 were included. All the patients aged from 21 to 79 years, body mass was from 43 to 91 kg, including 30 males and 53 females. The lumbar lordosis (LL), pelvic incidence (PI) and spondylolisthesis rate were measured on the lateral lumbar X-ray, and the patients were then assigned based on these indexes. L₅/S₁ intervertebral disc degeneration was measured on lumbar sagittal MRI using the modified Pfirrmann grading system.

RESULTS AND CONCLUSION: (1) Grouped by PI, the degeneration of disc and LL were the severest in the PI > 60° group, followed by normal (PI: 45°-60°) group, and the lowest in the PI < 45° group. The spondylolisthesis rate in the PI > 60° group was significantly higher than that in the PI < 45° group. (2) Grouped by degeneration of disc, highly severe group had significantly greater spondylolisthesis rate than that in the low severe group and mild-moderate groups, and the low severe group had significantly greater spondylolisthesis rate than that in the mild-moderate group. LL in the highly severe group was significantly greater than that in the low severe and mild-moderate groups, and there was no significant difference between low severe and mild-moderate groups. (3) As for LL, there was no significant difference between group with < 25% spondylolisthesis rate and group with 25%-50% spondylolisthesis rate. (4) Spino-pelvic parameters interact with progress of L₅isthmic spondylolisthesis. PI is closely related to lumbar morphology, degeneration of L₅/S₁disc and progress of spondylolisthesis. Degeneration of L_5/S₁disc probably affects lumbar morphology and progress of spondylolisthesis. Mild and moderate spondylolisthesis cannot change the LL probably. Clinically surgeons should pay more attention on patients with great PI.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Lumbar Vertebra, Spondylolysis, Tissue Engineering

CLC Number:

R318

Long Fa-yu, Chen Yao-wu, Zhong Zhao-ming, Wu Qian, Zheng Shuai, Chen Jian-ting . Interaction effect of spino-pelvic parameters and progress of L₅ isthmic spondylolisthesis[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(27): 4400-4404.

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References

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Interaction effect of spino-pelvic parameters and progress of L₅ isthmic spondylolisthesis

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