J Korean Neurosurg Soc.  2013 Feb;53(2):96-101. 10.3340/jkns.2013.53.2.96.

Difference of Sagittal Spinopelvic Alignments between Degenerative Spondylolisthesis and Isthmic Spondylolisthesis

• Lim JK
• Kim SM

• KMID: 2190685
• DOI: http://doi.org/10.3340/jkns.2013.53.2.96

Abstract

OBJECTIVE
The purpose of this study was to analyze the differences of spinopelvic parameters between degenerative spondylolisthesis (DSPL) and isthmic spondylolisthesis (ISPL) patients.
METHODS
Thirty-four patients with DSPL and 19 patients with ISPL were included in this study. Spinopelvic parameters were evaluated on whole spine X-rays in a standing position. The following spinopelvic parameters were measured : pelvic incidence (PI), sacral slope, pelvic tilt (PT), lumbar lordosis (LL), and sagittal vertical axis from C7 plumb line (SVA). The population of patients was compared with a control population of 30 normal and asymptomatic adults.
RESULTS
There were statistically significant differences in LL (p=0.004) and SVA (p=0.005) between the DSPL and ISPL group. The LL of DSPL (42+/-13degrees) was significantly lower than that of the control group (48+/-11degrees; p=0.029), but that of ISPL (55+/-6degrees) was significantly greater than a control group (p=0.004). The SVA of DSPL (55+/-49 mm) was greater than that of a control group (<40 mm), but that of ISPL (21+/-22 mm) was within 40 mm as that of a control group. The PT of DSPL (24+/-7degrees) and ISPL (21+/-7degrees) was significantly greater than that of a control group (11+/-6degrees; p=0.000).
CONCLUSION
Both symptomatic DSPL and ISPL patients had a greater PI than that of the asymptomatic control group. In conclusion, DSPL populations are likely to have global sagittal imbalance (high SVA) compared with ISPL populations because of the difference of lumbar lordosis between two groups.

Keyword

Spinopelvic alignment; Pelvic incidence; Lumbar lordosis; Degenerative spondylolisthesis; Isthmic spondylolisthesis

MeSH Terms

Animals
Axis, Cervical Vertebra
Humans
Incidence
Lordosis
Spine
Spondylolisthesis

Figure

• 

  Fig. 1 Illustration showing the spinopelvic parameters included in this study. A : This illustration displays the pelvic incidence (PI), the sacral slope (SS) and the pelvic tilt (PT). B : This illustration displays the lumbar lordosis (LL) and the sagittal vertical axis from C7 plumb line (SVA).

• 

  Fig. 2 The comparison of spinopelvic parameters between DSPL and ISPL. Lumbar lordosis (LL) and sagittal vertical axis from C7 plumb line (SVA) had statistically significant differences between the DSPL and ISPL group. *This is significantly (p<0.05) different between groups by the Mann-Whitney U test. DSPL : degenerative spondylolisthesis, ISPL : isthmic spondylolisthesis, PI : pelvic incidence, SS : sacral slope, PT : pelvic tilt.

• 

  Fig. 3 Illustration showing the difference of sagittal spinopelvic alignment between DSPL (A) and ISPL (B). A : This illustration displays the sagittal spinopelvic alignment of DSPL. B : This illustration displays the sagittal spinopelvic alignment of ISPL. DSPL : degenerative spondylolisthesis, ISPL : isthmic spondylolisthesis, SVA : sagittal vertical axis from C7 plumb line.

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