Skip to main content
SpringerLink
Log in

Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Introduction

The aim of this prospective study was to assess the sagittal alignment of the spine and pelvis before and after surgical treatment of isthmic spondylolisthesis with flat sacrum. At the same time, the functional outcome was analyzed and correlation examined.

Materials and methods

This study comprises analysis of 30 subjects (mean age 43 years) with isthmic spondylolisthesis and an average follow-up of 2.5 years after posterior spinal fusion. Radiological spinopelvic parameters were measured and functional evaluation was made using the Oswestry Disability Index.

Results

Significant improvement toward more normal values for PT and SS in relation to PI was observed after surgery. Pelvic incidence was unaffected by surgery. Correction of the spinosacral angle shows that the anterior tilt with anterior sagittal imbalance due to spondylolisthesis may be corrected by reduction and fusion of the slipped level. Functional outcome was satisfactory with a statistically significant difference between preoperative values and final follow-up values. The sub-group of patients with insufficient restoration of sagittal balance parameters had less good outcomes than the others.

Discussion and Conclusion

Surgical management of low- and mid-grade isthmic spondylolisthesis showed good clinical outcome with restoration of correct values for the pelvic position-dependent parameters, i.e., pelvis tilt, sacral slope, C7 plumb line position and SSA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Barrey C, Jund J, Perrin G, Roussouly P (2007) Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery 61:981–986

    Article  PubMed  Google Scholar 

  2. Carreon LY, Glassman SD, Howard J (2008) Fusion and nonsurgical treatment for symptomatic lumbar degenerative disease: a systematic review of Oswestry Disability Index and MOS Short Form-36 outcomes. Spine J 8:747–755

    Article  PubMed  Google Scholar 

  3. Debarge R, Demey G, Roussouly P (2009) Radiological analysis of ankylosing spondylitis patients with severe kyphosis before and after pedicle subtraction osteotomy. Eur Spine J 19:65–70

    Article  PubMed  Google Scholar 

  4. Dubousset J (1997) Treatment of spondylolysis and spondylolisthesis in children and adolescents. Clin Orthop Relat Res 337:77–85

    Article  PubMed  Google Scholar 

  5. Goyal N, Wimberley DW, Hyatt A, Zeiller S, Vaccaro AR, Hilibrand AS, Albert TJ (2009) Radiographic and clinical outcomes after instrumented reduction and transforaminal lumbar interbody fusion of mid and high-grade isthmic spondylolisthesis. J Spinal Disord Tech 22:321–327

    Article  PubMed  Google Scholar 

  6. Hresko MT, Hirschfeld R, Buerk AA, Zurakowski D (2009) The effect of reduction and instrumentation of spondylolisthesis on spinopelvic sagittal alignment. J Pediatr Orthop 29:157–162

    Article  PubMed  Google Scholar 

  7. Hresko MT, Labelle H, Roussouly P, Berthonnaud E (2007) Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction. Spine 32:2208–2213

    Article  PubMed  Google Scholar 

  8. Kwon BK, Hilibrand AS, Malloy K, Savas PE, Silva MT, Albert TJ, Vaccaro AR (2005) A critical analysis of the literature regarding surgical approach and outcome for adult low-grade isthmic spondylolisthesis. J Spinal Disord Tech 18(Suppl):S30–S40

    Article  PubMed  Google Scholar 

  9. Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O’Brien M (2005) The importance of spino-pelvic balance in L5–s1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine 30(Suppl):S27–S34

    Article  PubMed  Google Scholar 

  10. Labelle H, Roussouly P, Chopin D, Berthonnaud E, Hresko T, O’Brien M (2008) Spino-pelvic alignment after surgical correction for developmental spondylolisthesis. Eur Spine J 17:1170–1176

    Article  PubMed  Google Scholar 

  11. Lazennec JY et al (2000) Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J 9:47–55

    Article  PubMed  CAS  Google Scholar 

  12. Legaye J, Duval-Beaupere G, Hecquet J, Marty C (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7:99–103

    Article  PubMed  CAS  Google Scholar 

  13. Molinari RW, Bridwell KH, Lenke LG, Baldus C (2002) Anterior column support in surgery for high-grade, isthmic spondylolisthesis. Clin Orthop Relat Res 394:109–120

    Article  PubMed  Google Scholar 

  14. Moller H, Hedlund R (2000) Surgery versus conservative management in adult isthmic spondylolisthesis–a prospective randomized study: part 1. Spine 25:1711–1715

    Article  PubMed  CAS  Google Scholar 

  15. Roussouly P, Gollogly S, Berthonnaud E, Dimnet J (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine 30:346–353

    Article  PubMed  Google Scholar 

  16. Schwab F, Lafage V, Patel A, Farcy JP (2009) Sagittal plane considerations and the pelvis in the adult patient. Spine 34:1828–1833

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Spine Unit 2, Bordeaux University Hospital, CHU Pellegrin, 33076, Bordeaux, France

    A. Bourghli, S. Aunoble, O. Reebye & J. C. Le Huec

Authors
  1. A. Bourghli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Aunoble
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. O. Reebye
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. C. Le Huec
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. C. Le Huec.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bourghli, A., Aunoble, S., Reebye, O. et al. Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis. Eur Spine J 20 (Suppl 5), 663 (2011). https://doi.org/10.1007/s00586-011-1934-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00586-011-1934-z

Keywords

Search

Navigation