Different Types of Double-Level Degenerative Lumber Spondylolisthesis: What Is Different in the Sagittal Plane?
| Autor: | Ming-Qiang Liu, Xuewen Kang, Yicheng Gao, Guangzhi Zhang, Zuo-Long Wu, Zhanjun Ma, Liang Yang, Ya-Jun Deng, Xudong Guo, Yidian Wang, Xuegang He, Daxue Zhu, Fengguang Yang, En-Hui Ren |
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| Rok vydání: | 2020 |
| Předmět: |
Pelvic tilt
Male medicine.medical_specialty Radiography Neurogenic claudication Intervertebral Disc Degeneration Neurosurgical Procedures Pelvis 03 medical and health sciences Disability Evaluation 0302 clinical medicine medicine Humans Kyphosis Aged Retrospective Studies Orthodontics Lumbar Vertebrae business.industry Middle Aged medicine.disease Spondylolisthesis Sagittal plane Vertebra Oswestry Disability Index medicine.anatomical_structure Spinal Fusion 030220 oncology & carcinogenesis Orthopedic surgery Lordosis Surgery Female Neurology (clinical) medicine.symptom business Low Back Pain 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 150 |
| ISSN: | 1878-8769 |
| Popis: | Degenerative lumber spondylolisthesis (DLS) is a common orthopedic condition, described as a condition that compared with the lower vertebra, the superior vertebra slides forward or backward in the sagittal plane without accompanying isthmic spondylolisthesis. Information pertaining to different types of double-level DLS is scarce. This study aims to analyze parameters of patients with different types of double-level DLS to provide a reference for guiding surgical treatment and restoring sagittal balance of patients with DLS.From January 2014 to January 2020, records of patients with double-level DLS were retrospectively reviewed. Patients with double-level DLS were divided into 3 types: anterior, posterior, and combined; the anterior and combined types were studied. The sagittal spinopelvic parameters included C7 tilt, maximal thoracic kyphosis, maximal lumbar lordosis (LLmax), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). After descriptive analysis, demographic and radiographic data were compared.Forty and 18 patients were included in the anterior and combined type groups, respectively. Both groups had different levels of chronic low back pain, but the incidence of radiating leg pain and neurogenic claudication was significantly higher in the anterior type. Oswestry Disability Index and visual analog scale low back scores were also higher in the anterior type. In the anterior type, C7 tilt (7.14 ± 2.15 vs. 5.41 ± 2.28, P = 0.007), LLmax (50.02 ± 14.76 vs. 36.96 ± 14.56, P = 0.003), PI (68.28 ± 9.16 vs. 55.53 ± 14.19, P0.001), PT (28.68 ± 7.31 vs. 19.38 ± 4.70, P0.001), and PT/PI (42.45 ± 11.22 vs. 36.04 ± 9.87, P = 0.041) were significantly higher. In the anterior type, PI correlated positively with LLmax (r = 0.59) and SS (r = 0.71). LLmax and SS (r = 0.65) had a positive correlation. PT/PI and SS (r = -0.77) had a negative correlation. In the combined type, PI correlated positively with LLmax (r = 0.61) and SS (r = 0.88), and PT/PI correlated negatively with SS (r = -0.81).In patients with double-level DLS, the sagittal spinopelvic parameters differed between the anterior and combined types. Overall, spinal surgeons should focus on correcting sagittal deformities, relieving postoperative clinical symptoms, and improving quality of life during fusion surgery. |
| Databáze: | OpenAIRE |
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