Characteristics and Clinical Significance of Spondylolisthetic and Spino-pelvic Sagittal Parameters in Kyphotic Low-grade Degenerative Lumbar Spondylolisthesis

Abstract

Background: Degenerative lumbar spondylolisthesis (DLS) has been a common disease that make increasing patients suffer from different degrees of low back pain and radicular symptoms. At present, the incidence of kyphosis in DLS and the differences in spinal sagittal morphology between kyphotic and non-kyphotic DLS still remain unclear. Our study aimed to determine the incidence of kyphosis in DLS, explore the characteristics of spondylolisthetic and spino-pelvic sagittal parameters, and evaluate the impact of kyphosis on the life quality of patients with DLS.Methods/Design: All 108 patients with L4/5 low-grade DLS were enrolled and divided into kyphotic and non-kyphotic group. 2 spine surgeons who have certain clinical experience were selected to measure the spondylolisthetic and spino-pelvic parameters, as well as visual analogue scale (VAS) and Oswestry disability index (ODI). Differences between the 2 groups and characteristics of measurements were analyzed.Results: The inter-observer agreement of all parameters between the 2 spine surgeons were excellent with each ICC > 0.75. Kyphotic group had higher SA, SD, SDM, SAM, PDH, PT and SVA, and lower ADH, SS and LL than those in non-kyphotic group (p < 0.01). There was no significant difference in PI and TK between the two groups (p > 0.05).Conclusion: The incidence of kyphotic spondylolisthesis in patients with L4/5 low-grade DLS is 16.7%. Compared with those in non-kyphotic group, patients with kyphosis show inferior results of spondylolisthetic parameters, more severe loss of LL, more obvious pelvic retroversion and trunk anteversion, which indicates worse spino-pelvic sagittal balance. In addition, their quality of life was significantly lower than that of patients in non-kyphotic group.