Difference of Sagittal Alignment between Adolescents with Symptomatic Lumbar Isthmic Spondylolisthesis and the General Population

作者：Zhao, Jian; Xiao, Yongqiang; Zhai, Xiao; Chen, Ziqiang^*; Li, Ming^*

来源：Scientific Reports, 2018, 8(1): 10956.

DOI：10.1038/s41598-018-29260-6

• QUALITY-OF-LIFE
• IDIOPATHIC SCOLIOSIS
• PELVIC PARAMETERS
• SPINAL DEFORMITY
• NATURAL-HISTORY
• CHILDREN
• SPONDYLOLYSIS
• BALANCE
• ADULTS
• ASSOCIATION

This case-control study aimed to investigate differences in the sagittal spinal parameters between the symptomatic spondylolisthesis patients and the general population. Twenty-nine adolescent patients with symptomatic lumbar isthmic spondylolisthesis were included. For each patient, two age-matched, gender-matched and BMI-matched controls were enrolled. Comparison analyses detected higher values in the case group for the following parameters: CL (-22.06 +/- 7.552 degrees versus -20.36 +/- 7.016 degrees, P < 0.001), T1 Slope (19.84 +/- 8.708 degrees versus 13.99 +/- 6.537 degrees, P = 0.001), PT (21.54 +/- 9.082 degrees versus 8.87 +/- 7.863 degrees, P < 0.001), PI (64.45 +/- 13.957 degrees versus 43.60 +/- 9.669 degrees, P < 0.001), SS (42.90 +/- 9.183 degrees versus 34.73 +/- 8.265 degrees, P < 0.001), LL (-50.82 +/- 21.596 degrees versus -43.78 +/- 10.356 degrees, P = 0.042), SVA (16.99 +/- 14.625 mm versus 0.32 +/- 31.824 mm, P = 0.009), L5 Slope (33.95 +/- 13.567 degrees versus 19.03 +/- 6.809 degrees, P < 0.001), and L5I (8.90 +/- 6.556 degrees versus 1.29 +/- 6.726 degrees, P < 0.001). Conversely, TS-CL (6.56 +/- 6.716 degrees versus 11.04 +/- 7.085 degrees, P = 0.006), cSVA (11.31 +/- 6.867 mm versus 17.92 +/- 11.832 mm, P = 0.007), and TLK (-2.66 +/- 10.101 degrees versus 2.71 +/- 7.708 degrees, P = 0.007) were smaller in the case group. Slippage percentage was most correlated with PI (r = 0.530, P = 0.003), followed by PT (r = 0.465, P = 0.011) and L5I (r = 0.433, P = 0.019). Results of binary logistic regression showed that the main risk factor of isthmic spondylolisthesis was PI (OR = 1.145, 95% CI = 1.083-1.210, P < 0.001). Further subgroup analysis also showed that PI was the main risk factor of isthmic spondylolisthesis in the female adolescents (OR = 1.237, 95% CI = 1.086-1.493, P = 0.003) and in the male adolescents (OR = 1.523, 95% CI = 1.093-2.123, P = 0.013). PI was the main risk factor for adolescent symptomatic isthmic spondylolisthesis in the Chinese Han adolescents. The greater PI indicated the higher the progressive risk of spondylolisthesis. In these isthmic spondylolisthesis adolescents, the body always inclined forward and lumbar and cervical lordosis increased.

• 出版日期2018-7-19
• 单位中国人民解放军第二军医大学