Abstract
Introduction
To date, few studies have focused on spinopelvic sagittal alignment as a predisposing factor for the development of degenerative spondylolisthesis (DS). The objectives of this study were to compare differences in spinopelvic sagittal alignment between patients with or without DS and to elucidate factors related to spinopelvic sagittal alignment.
Materials and methods
A total of 100 patients with or without DS who underwent surgery for lumbar spinal canal stenosis were assessed in this study. Fifty patients with DS (DS group) and 50 age- and gender-matched patients without DS (non-DS group) were enrolled. Spinopelvic parameters including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), L4 slope, L5 slope, thoracic kyphosis (TK), lumbar lordosis (LL) and sagittal balance were compared between the two groups. In the DS group, the percentage of vertebral slip (% slip) was also measured.
Results
Several spinopelvic parameters, PI, SS, L4 slope, L5 slope, TK and LL, in the DS group were significantly greater than those in the non-DS group, and PI had positive correlation with % slip (r = 0.35, p < 0.05). Degrees of correlations among spinopelvic parameters differed between the two groups. In the DS group, PI was more strongly correlated with SS (r = 0.82, p < 0.001) than with PT (r = 0.41, p < 0.01). In the non-DS group, PI was more strongly correlated with PT (r = 0.73, p < 0.001) than with SS (r = 0.38, p < 0.01).
Conclusions
Greater PI may lead to the development and the progression of vertebral slip. Different compensatory mechanisms may contribute to the maintenance of spinopelvic sagittal alignment in DS and non-DS patients.
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References
Aono K, Kobayashi T, Jimbo S, Atsuta Y, Matsuno T (2010) Radiographic analysis of newly developed degenerative spondylolisthesis in a mean twelve-year prospective study. Spine 35:887–891
Barry C, Jund J, Noseda O et al (2007) Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J 16:1459–1467
Barry C, Jund J, Perrin G et al (2007) Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurg 61:981–986
Cinotti G, Postacchini F, Fassari F et al (1997) Predisposing factors in degenerative spondylolisthesis: A radiographic and CT study. Intern Orthop 21:337–342
Dai LY (2001) Orientation and tropism of lumbar facet joints in degenerative spondylolisthesis. Intern Orthop (SICOT) 25:40–42
Duval-Beaupère G, Schmidt C, Cosson P (1992) A barycentremetric study of the sagittal shape of spine and pelvis: the conditions required for an economic standing position. Ann Biomed Eng 20:451–462
Faro FD, Marks MC, Pawelek J et al (2004) Evaluation of a functional position for lateral radiograph acquisition in adolescent idiopathic scoliosis. Spine 15:2284–2289
Gelb DE, Lenke LG, Bridwell KH et al (1995) An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers. Spine 20:1351–1358
Grobler LJ, Robertson PA, Novotny JE et al (1993) Etiology of spondylolisthesis: assessment of the role played by lumbar facet joint morphology. Spine 18:80–91
Imada K, Matsui H, Tsuji H (1995) Oophorectomy predisposes to degenerative spondylolisthesis. J Bone Joint Surg [Br] 77-B: 126–130
Jackson RP, Peterson MD, McManus AC et al (1998) Compensatory spinopelvic balance over the hip axis and better reliability in measuring lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients. Spine 16(23):1750–1767
Kalichman L, Li L, Hunter DJ, Been E (2011) Association between computed tomography-evaluated lumbar lordosis and features of spinal degeneration, evaluated in supine position. Spine J 11:308–315
Kanemura T, Kawakami N, Matsubara Y, Katayama Y, Imagama S, Matsuyama Y, Gotou M (2003) Sagittal spinopelvic alignment in adult Japanese. J Japanese Scoliosis Soc (Spinal Deformity) 18:150–155 (in Japanese)
Legaye J, Duval-Beaupère G, Hecquet J et al (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7:99–103
Mac-Thiong J-M, Wang Z, Guise JA et al (2008) Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis. Spine 33:2316–2325
Matsunaga S, Sakou T, Morizono Y et al (1990) Natural history of degenerative spondylolisthesis: pathogenesis and natural course of the slippage. Spine 15:1204–1210
Rose PS, Bridwell KH, Lenke LG et al (2009) Role of pelvic incidence, thoracic kyphosis, and patient factors on sagittal plane correction following pedicle subtraction osteotomy. Spine 34:785–791
Rosenberg NJ (1975) Degenerative spondylolisthesis: predisposing factors. J Bone Joint Surg [Am] 57-A :467–474
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
Sanderson PL, Fraser RD (1996) The influence of pregnancy on the development of degenerative spondylolisthesis. J Bone Joint Surg [Br] 78-B: 951–954
Sato K, Wakamatsu E, Yoshizumi A et al (1989) The configuration of the laminas and facet joints in degenerative spondylolisthesis. Spine 14:1265–1271
Schuller S, Charles YP, Steib JP (2011) Sagittal spinopelvic alignment and body mass index in patients with degenerative spondylolisthesis. Eur Spine J 20:713–719
Stagnara P, De Mauroy JC, Dran G et al (1982) Reciprocal angulation of vertebral bodies in a sagittal plane. Approach to references for the evaluation of kyphosis and lordosis. Spine 7:335–342
Vaz G, Roussouly P, Berthonnaud E, Dimnet J (2002) Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J 11:80–87
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Funao, H., Tsuji, T., Hosogane, N. et al. Comparative study of spinopelvic sagittal alignment between patients with and without degenerative spondylolisthesis. Eur Spine J 21, 2181–2187 (2012). https://doi.org/10.1007/s00586-012-2374-0
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DOI: https://doi.org/10.1007/s00586-012-2374-0