| BackgroundWith the in-depth researches about biomechanics spinal sagittal,morphology parameters and sequence of spine and pelvis play an very important role to maintain the spinal sagittal balance,Sagittal spine and pelvis related parameters are abnormal in patients with spine-related diseases.Patients with lumbar spondylolisthesis and lumbar vertebral spondylolisthesis lead to spinal sagittal balance again,as a typical spinal sagittal imbalance to balance,provide good material for the study of the relationship between pelvic sequence and parameters and spinal sagittal parameters.With the improvement of current radiography technique and the widely used image analysis software,the relationship between the sequence parameters of spinal sagittal plane and the alignment parameters of pelvis in lumbar spondylolisthesis has been reported in many literatures.The results show not only the lumbar spondylolysis and spondylolisthesis of lumbar vertebral bodies,but the entire spine appear a series of sagittal parameters in the sagittal changes.On the causal relationship between lumbar spondylolisthesis sagittal imbalance and spondylolisthesis is unclear.At present,there are many reports on the sagittal plane parameters of the spine in adult patients with lumbar spondylolisthesis,while there are relatively few reports on the sagittal plane parameters of the spine in adolescent patients with lumbar spondylolisthesis.In particular,the comparison of the sagittal morphology of the spine and pelvis in adolescent developmental lumbar spondylolisthesis and isthmic spondylolisthesis has not been observed.In order to understand the problem in this experiment to select our adolescent growth and spondylolysis patients with lumbar spine,in the whole spine including bilateral hip X-ray radiography on determination of spinal sagittal morphology and pelvic morphology and the related parameters to compare the correlation between the parameters in order to understand the differences and gives relevant references for clinical treatment.Objective:To compare the sagittal morphological features of the spine and pelvis between adolescent L5S1 dysplastic slippage and isthmus spondylolisthesis.Method:Retrospective analysis of 24 cases of adolescent L5S1 spondylolisthesis with complete imaging data from May 2002 to December 2016.Those include 8 men and 16 women,aged 10-18 years,mean(13.4±2.0)years.Among them,9 cases were diagnosed as dysplastic spondylolisthesis(dysplasia group)and 15 cases isthmic spondylolisthesis(ischemic group).Radiographic parameters including slippage distance,slip ratio,slip angle,sagittal vertical axis(SVA),thoracic kyphosis(TK),lumbar lordosis(LL),L5 incidence(L5I),pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),sagittal pelvic thickness(SPT),lumbosacral angle(LSA),sacral table angle(STA)were measured on the spinal lateral X ray of the standing position.Independent sample t-test for between group variable is compared.(P <0.05)was considered statistically significant.Results:The slippage distance,slip ratio and slip angle between the two groups did not differ significantly.In dysplasia group,SVA,L5 I,PT,SPT were(37.0±48.4)mm,(57.0±14.8)°,(42.3±15.4)°,(56.1±21.2)mm,respectively,and(-11.0± 22.2)mm,(31.7±19.3)°,(15.5±10.2)°,(31.4 ±19.1)mm,in ischemic group;and the difference between the two groups was significant(P<0.05).In ischemic group,SS,LSA,STA were(44.1±12.6)°,(103.9±21.7)°,(92.7±9.9)°,respectively,and(25.9±20.2)°,(75.4±16.4)°,(75.4±9.7)° in dysplasia group;The difference between groups was statistically significant(P < 0.05).There was no significant difference in TK,LL between two groups(P>0.05).Conclusion:Compared with the spinal spondylolisthesis,the type of spinal spondylolisthesis showed different sagittal position of spinal pelvis,which was characterized by forward tilt of torso and backward tilt of pelvis.In case of sagittal imbalance,early surgical intervention in order to restore balance spino pelvic alignment. |
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