Spinopelvic Alignment of Patients With Degenerative Spondylolisthesis

Abstract

Matching according to the PI between the patients in the study and the control group enabled us to understand variations of the spinopelvic parameters in a population of patients with DSPL. DSPL patients were characterized by a greater PI than the asymptomatic population; therefore, we suggest that a high PI may be a predisposing factor in developing DSPL. Finally, we observed significant variations in spinopelvic alignment, such as loss of lordosis and sagittal unbalance, which were partially compensated by pelvis back tilt and hyperextension in the upper lumbar spine.

Sagittal spinal alignment in patients with lumbar disc herniation

“…Previous studies suggested the association between the PRS1 and lumbar degenerative diseases [10,12,13]. The smaller PRS1 angle sometimes appear with the onset of certain lumbar degenerative disease.…”

“…The sciatic scoliotic list in LDH patients has also been investigated [1,2]. However, the relationship between sagittal spinal alignment and sciatic pain has not been quantified in detail [12,13].…”

“…Rather, it may be secondary to segmental discopathy or small loss of disc height, a postural change secondary to an analgesic response to avoid posterior disc hyperpression, or foraminal stenosis due to a herniated disc [12]. The observed lumbar lordotic changes might also correspond to a rotation of the pelvis around the coxofemoral joints by contraction of the hip extensor muscles [13]. Biomechanically, the loss of lordosis would result in anterior displacement of the C7 plumb line as well as a more vertical pelvic tilt (i.e., increase in PA) to compensate for the anterior translation of the gravitational axis [10].…”

Comparison of radiographic sagittal spinopelvic alignment between skeletally immature and skeletally mature individuals with Scheuermann’s disease

“…It is accepted that PI becomes fixed with skeletal maturation and remains constant in adulthood, unless there is a pathological process that can modify the shape of the pelvis [6,9,10]. Deviations in pelvic morphology and subsequently higher values of PI were found to be associated with spondylolisthesis and idiopathic scoliosis [11][12][13][14][15][16]. Significantly lower PI was reported in patients with post-tuberculosis or congenital thoracic and thoracolumbar kyphosis [17].…”

Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults

“…Because of its close relationship with the spine, many studies have investigated the influence of sacropelvic balance and morphology in the evaluation and treatment of spinal disorders, such as developmental spondylolisthesis [1][2][3][4][5][6][7][8][9][10][11][12], degenerative spondylolisthesis [13,14], adolescent idiopathic scoliosis [15][16][17], and adult spinal deformity [18][19][20]. Some authors have also raised the role of sacropelvic morphology and balance in the pathogenesis and surgical treatment of hip osteoarthritis [21][22][23][24].…”