Analyze The Morphological Changes Of Lumbar Intervertebral Space, Facet Joint And Pelvic In Patients With Degenerative Lumbar Spondylolisthesis

Objectives:Analyze the morphological changes of lumbar intervertenral space, facet joint and pelvic in patients with degenerative lumbar spondylolisthesis. To discuss the risk factors of degenerative lumbar spondylolisthesis. To provide a reference for prevention and treatment of degenerative lumbar spondylolisthesis.Methods:A retrospective study included 67 patients with degenerative lumbar spondylolisthesis and a control group of 70 asymptomatic volunteers at our hospital from 2006 to 2010. The parameters which were measured include:the degree of spondylolisthesis, lumbor intervertebral disc angle (LIDA), disc index (DI), facet joints orientation (FJO), facet joints tropism (FJT), pedicle-facet angle (PFA), pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT) and sacro-femoral distance(SFD). Statistical analysis:Statistical analysis was performed by using SPSS 17.0 statistical software. The unpaired t-test was used to compare the measurement data between two groups. The Pearson's correlation coefficients were used to compare the association among the parameters. All the independent variables were analyzed with the single-factor analysis and multiple-factor logistic regression analysis. The criterion for statistical significance was a=0.05.Result: LIDA, DI were significantly smaller in patients with degenerative lumbar spondylolisthesis compared with the control group (P<0.001). Patients with degenerative lumbar spondylolisthesis had more sagittally orientated facet joints, more significant facet joints tropism and more horizontally orientated pedicle-facet angle than the control group (P<0.001).PI, PT, SFD were significantly greater while SS was significantly smaller in patients with degenerative lumbar spondylolisthesis compared with the control group (P<0.001). The Pearson's correlation coefficients showed a significant correlation between PI and the degree of spondylolisthesis,LIDA (P<0.05). A significant correlation existed between DI and FJO,FJT(P<0.05).PFA and FJO had a significant correlation(P<0.01).There was a significant correlation among PI,SS,PT and SFD.Analysis of logistic regression model suggests that FJO, PFA and PI exert significant influences to DLS. The greater of PFA and PI, and the smaller of FJO are more susceptible to DLS.Conclusion:1.There were some abnormal conditions in patients with DLS:â‘ The height lost of intervertenral space,LIDA became more horizontally orientated even reverse angle.â‘¡More sagittally orientated facet joints more significant facet joints tropism and more horizontally orientated pedicle-facet angle.â‘¢The dysplastic pelvic which caused the pelvic to tilt backward. 2.More sagittally orientated facet joints, more horizontally orientated pedicle-facet angle and the increase of PI were risk factors of DLS. The increase of PI was the most likely to DLS,3.There were some significant correlations among the parameters of intervertenral space, facet joint and pelvic in patients with DLS:â‘ PI was obviously positive to the degree of spondylolisthesis, while PI was obviously negative to LIDA.It showed that there was a relationship between the dysplastic pelvic and the degree of spondylolisthesis, disc degeneration.â‘¡DI was obviously positive to FJO,while DI was obviously negative to FJT. It show that there is a relationship between disc degeneration and facet joint degeneration.