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Restoration of normal pelvic balance from surgical reduction in high-grade spondylolisthesis

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Abstract

Purpose

To investigate the effectiveness of surgical reduction in high-grade spondylolisthesis in maintaining or restoring a normal pelvic balance, as related to the QoL.

Methods

It is a retrospective analysis of prospectively collected data of 60 patients (17 males, 43 females) aged 15 ± 3.1 years who underwent surgery for high-grade spondylolisthesis and were followed for a minimum of 2 years after surgery. Patients with a residual high-grade slip following surgery were referred to the postoperative high-grade (PHG) group, while patients with a residual low-grade slip were referred to the postoperative low-grade (PLG) group. Pelvic balance was assessed from pelvic tilt and sacral slope, in order to identify patients with a balanced pelvis or unbalanced pelvis. The SRS-22 questionnaire was completed before surgery and at last follow-up.

Results

Postoperatively, there were 36 patients with a balanced pelvis and 24 patients with an unbalanced pelvis. The improvement in QoL was better in patients with a postoperative balanced pelvis. There were 14 patients in the PHG group and 46 patients in the PLG group. Four of seven patients (57%) in the PHG group and 21 of 26 patients (81%) in the PLG group with a preoperative balanced pelvis maintained a balanced pelvis postoperatively (P = 0.1). None of the patients in the PHG group and 11 of 20 patients (55%) in the PLG group improved from an unbalanced to a balanced pelvis postoperatively (P < 0.05).

Conclusions

Surgical reduction in high- to low-grade slip is more effective in maintaining and restoring a normal pelvic balance postoperatively.

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Acknowledgements

This work was supported by a Standard Investigator Research Grant from the Scoliosis Research Society. This study is approved by Hospital’s Research Ethics Committee.

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Authors and Affiliations

  1. University of Montreal, Montreal, Canada

    Abdulmajeed Alzakri, Hubert Labelle, Stefan Parent & Jean-Marc Mac-Thiong

  2. Hôpital du Sacré-Cœur, Montreal, Canada

    Abdulmajeed Alzakri, Stefan Parent & Jean-Marc Mac-Thiong

  3. Division of Orthopaedic Surgery, CHU Sainte-Justine, 3175 Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada

    Hubert Labelle, Stefan Parent & Jean-Marc Mac-Thiong

  4. Orthopedic Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Abdulmajeed Alzakri

  5. Department of Orthopaedic Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Michael T. Hresko

  6. Texas Scottish Rite Hospital, Dallas, TX, USA

    Daniel J. Sucato

  7. Columbia University College of Physicians and Surgeons, New York, NY, USA

    Lawrence G. Lenke

  8. Setting Scoliosis Straight Foundation, San Diego, CA, USA

    Michelle C. Marks

  9. Department of Surgery, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montreal, QC, H4J 1C5, Canada

    Jean-Marc Mac-Thiong

Authors
  1. Abdulmajeed Alzakri
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  2. Hubert Labelle
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  3. Michael T. Hresko
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  4. Stefan Parent
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  5. Daniel J. Sucato
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  6. Lawrence G. Lenke
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  7. Michelle C. Marks
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  8. Jean-Marc Mac-Thiong
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Corresponding author

Correspondence to Jean-Marc Mac-Thiong.

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Conflict of interest

J-M Mac-Thiong, H Labelle and S Parent are a co-founders, board members and shareholders of Spinologics Inc. J-M Mac-Thiong receives research support from Medtronic and Depuy-Synthes. S Parent receives research support from DePuy-Synthes. LG Lenke receives royalties from Medtronic and Quality Medical Publishing, is a consultant for Medtronic, and receives research support from EOS Imaging. DJ Sucato is a consultant from Globus.

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Alzakri, A., Labelle, H., Hresko, M.T. et al. Restoration of normal pelvic balance from surgical reduction in high-grade spondylolisthesis. Eur Spine J 28, 2087–2094 (2019). https://doi.org/10.1007/s00586-019-05973-8

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  • DOI: https://doi.org/10.1007/s00586-019-05973-8

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