The Association of Sagittal Spinal and Pelvic Parameters in Asymptomatic Persons and Patients with Isthmic Spondylolisthesis

Rajnics, Péter; Templier, Alexandre; Skalli, Wafa; Lavaste, F.; Illés, Tamás

doi:10.1097/00024720-200202000-00004

Cited by 142 publications

(102 citation statements)

References 12 publications

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“…In a cohort of 39 subjects with spondylolysis and low-grade (I or II) spondylolisthesis, Marty et al [17] noted a greater PI and SS, and postulated (as have Labelle et al [11,12]) that this increased PI could predispose to spondylolisthesis, since PI is specific and remains constant for each individual after childhood. The same findings were reported by Rajnic et al [19] in a cohort of 48 adults with low-grade isthmic. In addition, Hanson et al [9] reported that PI was significantly higher in 40 patients with spondylolisthesis as compared with controls and PI was correlated with the grade of slipping.…”

Section: Discussionsupporting

confidence: 89%

Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study

et al. 2007

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Recent studies suggested a predominant role of spinopelvic parameters to explain lumbosacral spondylolisthesis pathogeny. We compare the pelvic incidence and other parameters of sagittal spinopelvic balance in adolescents and young adults with developmental spondylolisthesis to those parameters in a control group of healthy volunteers. We compared the angular parameters of the sagittal balance of the spine in a cohort of 244 patients with a developmental L5-S1 spondylolisthesis with those of a control cohort of 300 healthy volunteers. A descriptive and correlation study was performed. The L5 anterior slipping and lumbosacral kyphosis in spondylolisthesis patients was described using multiple regression analysis study. Our study demonstrates that the related measures of sagittal spinopelvic alignment are disturbed in adolescents and young adults with developmental spondylolisthesis. These subjects stand with an increased sacral slope, pelvic tilt and lumbar lordosis but with a decreased thoracic kyphosis. Pelvic incidence was significantly higher in spondylolisthesis patients as compared with controls but was not clearly correlated with the grade of slipping. We showed the same ''sagittal balance strategy'' in spondylolisthesis patients as in the control group regarding correlations between pelvic incidence, sacral slope, pelvic tilt and lumbar lordosis. We believe that the lumbosacral kyphosis is a stronger factor than pelvic incidence which need to be taken into account as a predominant factor in theories of pathogenesis of lumbosacral spondylolithesis. We thus believe that increased lumbar lordosis associated with L5-S1 spondylolisthesis is secondary to the high pelvic incidence and is an important factor causing high shear stresses at the L5-S1 pars interarticularis. However, the ''local'' sagittal imbalance of the lumbosacral junction is compensated by adjacent mobile segments in the upper lumbar spine, the pelvis orientation and the thoracic spine. The result is not optimal but a satisfactory global sagittal balance of the trunk, even in the most severe grade of slipping.

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Section: Discussionsupporting

confidence: 89%

Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study

et al. 2007

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“…Another factor is the role an individual's sacropelvic geometry may play in these outcomes. Pelvic incidence has been shown to be associated with spondylolysis, progression of spondylolisthesis, and degree of degenerative disc disease at L5-S1 [14,23,30,34,42,43]. It could be possible that pelvic incidence or sacral inclination may have the same effect on spondylolysis at L4 and may account for some of the greater than predicted amount of degenerative disc disease we found in specimens with L4 lesions.…”

Section: Discussionmentioning

confidence: 76%

“…Toy et al [49] found sacral inclination and degenerative disc disease, and pelvic incidence and degenerative disc disease, to be associated at the L5-S1 level. Pelvic incidence has been shown to correlate with spondyloarthrosis [14], and spondylolysis and spondylolisthesis [23,30,34,42,43]. However, none of these previous articles mentioned the effect that pelvic incidence had on the L4-L5 motion segment.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Pars Defects at the L4 Vertebra Result in Increased Degeneration When Compared With Those at L5: An Anatomic Study

McCunniff

Yoo

Dugarte

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Cadaveric studies have examined disc degeneration at the L4-L5 and L5-S1 motion segments; however, we are not aware of another study that has examined the relationship between bilateral spondylolysis and its effect on degenerative disc disease at those levels. This may have been overlooked by researchers owing to the majority of spondylolysis occurring at the L5 vertebra. Questions/purposes Using osteologic specimens from a collection that included individuals who died in one city in the USA between 1893 and 1938, we asked: (1) do specimens with bilateral spondylolysis (bilateral pars defects) have increased levels of disc degeneration, at their respective motion segments, when compared with matched controls without spondylolysis, and (2) is the finding of a bilateral pars defect associated with more severe arthritis at L4-L5 than at L5-S1? Methods An observational study was performed on 665 skeletal lumbar spines from the Hamann-Todd Osteologic Collection at the Cleveland Museum of Natural History (Cleveland, OH, USA). The specimens included 534 males and 131 females ranging from 17 to 87 years old, with a nearly bell-shaped distribution of ages for males and a larger proportion of younger ages in the female specimens. Of those with spondylolysis, 81 had a defect at L5 and 14 had a defect at L4. The gross specimens were examined subjectively for evidence of arthrosis. At the time of examination, specific attention was not paid to the coexisting presence or absence of spondylolysis nor was the examiner blinded to the age of the specimens. Disc degeneration was measured by the classification of Eubanks et al., a modified version of the Kettler and Wilke classification. Linear regression was performed to derive a formula that would predict the amount of disc degeneration at L4-L5 and L5-S1 for the normal control population given a specimen's age, sex, and race. We then used this formula to evaluate the difference in disc degeneration at the corresponding level of the pars defect that is greater Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This work was performed at the University Hospitals Case Medical Center and the Cleveland Museum of Natural History, Cleveland, OH, USA. P. T. McCunniff (&), Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® than the pr...

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“…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].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

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The Association of Sagittal Spinal and Pelvic Parameters in Asymptomatic Persons and Patients with Isthmic Spondylolisthesis

Cited by 142 publications

References 12 publications

Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study

Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study

Bilateral Pars Defects at the L4 Vertebra Result in Increased Degeneration When Compared With Those at L5: An Anatomic Study

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

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