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Radiological assessment of lumbosacral dystrophic changes in high-grade spondylolisthesis

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Abstract

Objective

To analyse radiographic correlates for the clinical status of patients and the deformation reducibility of high-grade lumbosacral spondylolisthesis. We also clarify the clinical and radiographic correlates of a new parameter for S1 dystrophy, the “S1 index”.

Design and patients

One hundred cases of high-grade isthmic lumbosacral spondylolisthesis were reviewed. We noted the dystrophic changes in the cranial sacral endplate, and the caudal endplate of L5. The severity of the spondylolisthesis was evaluated by measuring the lumbosacral kyphosis. The clinical status and the deformation reducibility (dependent on the stiffness of the deformation) were compared with these dystrophic patterns, the sagittal slope of S1 and S2 endplates and a sacral morphological marker, the S1 index.

Results

Lumbosacral kyphosis was less severe in cases with dystrophic changes of the posterior cranial edge of S1 and/or of the posterior caudal edge of L5 but its reducibility was worse. These patients were more functionally impaired. We describe and analyse this situation as a partial lumbosacral disc failure responsible for the less severe L5 slipping. The S1 index was strongly correlated with the grade of slipping, the lumbosacral kyphosis and its reducibility. We noted the same configuration among patients with a smaller S1 index, i.e. vertical S1 and S2 vertebral bodies associated with more severe but more reducible lumbosacral kyphosis.

Conclusion

Analysing specific criteria, we think it is possible to note progressive dystrophic changes according to the natural history of lumbosacral spondylolisthesis. We think that repeated measurements of these morphological parameters in patients diagnosed with a low-grade lumbosacral spondylolisthesis could be helpful in the early detection of evolving lumbosacral kyphosis and L5 slipping.

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Authors and Affiliations

  1. Department of Paediatric Orthopaedics, Armand Trousseau Hospital, 26 avenue du Docteur Arnold Netter, 75571, Paris Cedex 12, France

    Raphaël Vialle

  2. 105 avenue André Morizet, 92100, Boulogne Billancourt, France

    Raphaël Vialle

  3. Department of Paediatric Radiology, Necker-Enfants Malades Hospital, 149 rue de Sèvres, 75015, Paris, France

    Pierre Schmit

  4. Department of Orthopaedic Surgery, Beaujon Hospital, 100 Bd du Général Leclerc, 92118, Clichy Cedex, France

    Cyril Dauzac & Pierre Guigui

  5. Department of Paediatric Orthopaedics, Saint-Vincent de Paul Hospital, 82 avenue Denfert Rochereau, 75014, Paris, France

    Philippe Wicart

  6. Department of Paediatric Orthopaedics, Necker-Enfants Malades Hospital, 149 rue de Sèvres, 75015, Paris, France

    Christophe Glorion

Authors
  1. Raphaël Vialle
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  2. Pierre Schmit
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  3. Cyril Dauzac
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  4. Philippe Wicart
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  5. Christophe Glorion
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  6. Pierre Guigui
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Correspondence to Raphaël Vialle.

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Vialle, R., Schmit, P., Dauzac, C. et al. Radiological assessment of lumbosacral dystrophic changes in high-grade spondylolisthesis. Skeletal Radiol 34, 528–535 (2005). https://doi.org/10.1007/s00256-005-0948-1

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  • DOI: https://doi.org/10.1007/s00256-005-0948-1

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