DOI QR코드

DOI QR Code

The Comparison of Sagittal Spinopelvic Parameters between Young Adult Patients with L5 Spondylolysis and Age-Matched Control Group

  • Oh, Young Min (Department of Neurosurgery, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital) ;
  • Choi, Ha Young (Department of Neurosurgery, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital) ;
  • Eun, Jong Pil (Department of Neurosurgery, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital)
  • Received : 2013.07.07
  • Accepted : 2013.09.18
  • Published : 2013.09.28

Abstract

Objective : To compare spinopelvic parameters in young adult patients with spondylolysis to those in age-matched patients without spondylolysis and investigate the clinical impact of sagittal spinopelvic parameters in patients with L5 spondylolysis. Methods : From 2009 to 2012, a total of 198 young adult male patients with spondylolysis were identified. Eighty age-matched patients without spondylolysis were also selected. Standing lateral films that included both hip joints were obtained for each subject. Pelvic incidence (PI), sacral slope (SS), pelvic tilt, lumbar lordosis angle, sacral inclination, lumbosacral angle, and sacral table angle were measured in both groups. A comparative study of the spinopelvic parameters of these two groups was performed using SPSS 15.0 (SPSS Inc., Chicago, IL, USA). Results : Among the aforementioned spinopelvic parameters, PI, SS and STA were significantly different between patients with spondylolysis and those without spondylolysis. PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Conclusion : PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Patients with spondylolysis have low STA at birth, which remains constant during growth; a low STA translates into high SS. As a result, PI is also increased in accordance with SS. Therefore, we suggest that STA is an important etiologic factor in young adult patients with L5 spondylolysis.

Keywords

References

  1. Dubousset J : Treatment of spondylolysis and spondylolisthesis in children and adolescents. Clin Orthop Relat Res : 77-85, 1997
  2. Endo K, Suzuki H, Tanaka H, Kang Y, Yamamoto K : Sagittal spinal alignment in patients with lumbar disc herniation. Eur Spine J 19 : 435-438, 2010 https://doi.org/10.1007/s00586-009-1240-1
  3. Hresko MT, Labelle H, Roussouly P, Berthonnaud E : Classification of high-grade spondylolistheses based on pelvic version and spine balance : possible rationale for reduction. Spine (Phila Pa 1976) 32 : 2208-2213, 2007 https://doi.org/10.1097/BRS.0b013e31814b2cee
  4. Inoue H, Ohmori K, Miyasaka K : Radiographic classification of L5 isthmic spondylolisthesis as adolescent or adult vertebral slip. Spine (Phila Pa 1976) 27 : 831-838, 2002 https://doi.org/10.1097/00007632-200204150-00010
  5. Labelle H, Mac-Thiong JM, Roussouly P : Spino-pelvic sagittal balance of spondylolisthesis : a review and classification. Eur Spine J 20 Suppl 5 : 641-646, 2011 https://doi.org/10.1007/s00586-011-1932-1
  6. Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O'Brien M : The importance of spino-pelvic balance in L5-s1 developmental spondylolisthesis : a review of pertinent radiologic measurements. Spine (Phila Pa 1976) 30 (6 Suppl) : S27-S34, 2005
  7. Labelle H, Roussouly P, Berthonnaud E, Transfeldt E, O'Brien M, Chopin D, et al. : Spondylolisthesis, pelvic incidence, and spinopelvic balance : a correlation study. Spine (Phila Pa 1976) 29 : 2049-2054, 2004 https://doi.org/10.1097/01.brs.0000138279.53439.cc
  8. Legaye J, Duval-Beaupère G, Hecquet J, Marty C : Pelvic incidence : a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7 : 99-103, 1998 https://doi.org/10.1007/s005860050038
  9. Mac-Thiong JM, Wang Z, de Guise JA, Labelle H : Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis. Spine (Phila Pa 1976) 33 : 2316-2325, 2008 https://doi.org/10.1097/BRS.0b013e318186b236
  10. Mehta VA, Amin A, Omeis I, Gokaslan ZL, Gottfried ON : Implications of spinopelvic alignment for the spine surgeon. Neurosurgery 70 : 707-721, 2012 https://doi.org/10.1227/NEU.0b013e31823262ea
  11. Osterman K, Osterman H : Experimental lumbar spondylolisthesis in growing rabbits. Clin Orthop Relat Res : 274-280, 1996
  12. Roussouly P, Gollogly S, Berthonnaud E, Dimnet J : Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976) 30 : 346-353, 2005 https://doi.org/10.1097/01.brs.0000152379.54463.65
  13. Roussouly P, Gollogly S, Berthonnaud E, Labelle H, Weidenbaum M : Sagittal alignment of the spine and pelvis in the presence of L5-s1 isthmic lysis and low-grade spondylolisthesis. Spine (Phila Pa 1976) 31 : 2484-2490, 2006 https://doi.org/10.1097/01.brs.0000239155.37261.69
  14. Stagnara P, De Mauroy JC, Dran G, Gonon GP, Costanzo G, Dimnet J, et al. : Reciprocal angulation of vertebral bodies in a sagittal plane : approach to references for the evaluation of kyphosis and lordosis. Spine (Phila Pa 1976) 7 : 335-342, 1982 https://doi.org/10.1097/00007632-198207000-00003
  15. Vialle R, Ilharreborde B, Dauzac C, Lenoir T, Rillardon L, Guigui P : Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study. Eur Spine J 16 : 1641-1649, 2007 https://doi.org/10.1007/s00586-007-0348-4
  16. Vialle R, Levassor N, Rillardon L, Templier A, Skalli W, Guigui P : Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg Am 87 : 260-267, 2005 https://doi.org/10.2106/JBJS.D.02043
  17. Wang Z, Parent S, Mac-Thiong JM, Petit Y, Labelle H : Influence of sacral morphology in developmental spondylolisthesis. Spine (Phila Pa 1976) 33 : 2185-2191, 2008 https://doi.org/10.1097/BRS.0b013e3181857f70
  18. Whitesides TE Jr, Horton WC, Hutton WC, Hodges L : Spondylolytic spondylolisthesis : a study of pelvic and lumbosacral parameters of possible etiologic effect in two genetically and geographically distinct groups with high occurrence. Spine 30 : S12-S21, 2005 https://doi.org/10.1097/01.brs.0000155574.33693.60
  19. Wiltse LL, Winter RB : Terminology and measurement of spondylolisthesis. J Bone Joint Surg Am 65 : 768-772, 1983 https://doi.org/10.2106/00004623-198365060-00007

Cited by

  1. Spondylolysis in American Football Players: Etiology, Symptoms, and Implications for Strength and Conditioning Specialists vol.38, pp.5, 2016, https://doi.org/10.1519/ssc.0000000000000244
  2. Differences of Sagittal Lumbosacral Parameters between Patients with Lumbar Spondylolysis and Normal Adults vol.129, pp.10, 2013, https://doi.org/10.4103/0366-6999.181972
  3. Association between vertebral cross-sectional area and lumbar lordosis angle in adolescents vol.12, pp.2, 2013, https://doi.org/10.1371/journal.pone.0172844
  4. Increased Lumbar Lordosis and Smaller Vertebral Cross-Sectional Area Are Associated With Spondylolysis vol.43, pp.12, 2013, https://doi.org/10.1097/brs.0000000000002480
  5. Factors Associated with the Symptoms of Young Adults with L5 Spondylolysis vol.12, pp.3, 2018, https://doi.org/10.4184/asj.2018.12.3.476
  6. The Relationship Between Sacral Slope and Symptomatic Isthmic Spondylolysis in a Cohort of High School Athletes: A Retrospective Analysis vol.10, pp.5, 2018, https://doi.org/10.1016/j.pmrj.2017.09.012
  7. Acquired spondylolysis and spinopelvic sagittal alignment vol.28, pp.6, 2013, https://doi.org/10.1007/s00590-018-2182-2
  8. The Role of Sacral Slope in the Progression of a Bilateral Spondylolytic Defect at L5 to Spondylolisthesis: A Biomechanical Investigation Using Finite Element Analysis vol.8, pp.5, 2013, https://doi.org/10.1177/2192568217735802
  9. Pedicle Stress Injury in Children and Adolescents With Low Back Pain vol.44, pp.17, 2013, https://doi.org/10.1097/brs.0000000000003046
  10. Large Lumbar Lordosis Is a Risk Factor for Lumbar Spondylolysis in Patients with Adolescent Idiopathic Scoliosis vol.47, pp.1, 2013, https://doi.org/10.1097/brs.0000000000004192