The Correlation Of Realignment Of Sagittal Spine With Health-related Quality Of Life After Lumbar Spondylolisthesis Reduction

Objective: To evaluate the therapeutic effect of lumbar spondylolisthesis and to investigate the changes of the sagittal sequence of the spine before and after surgery and its correlation with HRQoL.Methods:Patients who underwent complete reduction of lumbar spondylolisthesis in our hospital from June 2012 to March 2016 were included in the standard.The patients were included in the standard follow-up period of more than 2years.The standard standing position and the X-ray of the main spine were taken before and after the video.The slice(including the positive slice)was used to measure the sagittal parameters of the spine,and the HRQoL scores of the preoperative and postoperative follow-up were evaluated.Related measurement parameters include: thoracic entrance angle(TIA),cervical tilt(Cervical tilt),cervical tilt(NT),cranial tilt,thoracic kyphosis(TK),lumbar lordosis(LL),T1 pelvis Angle(TPA),pelvic angle of incidence(PI),sagittal sagittal balance(SVA),sacral tilt angle(SS),and pelvic tilt angle(PT).The HRQoL rating scale includes:the Concise Health Survey Scale Physiological Total Score(SF-36 PCS),the Oswestry Dysfunction Index(ODI),and the SRS-22 Questionnaire(SRS-22).The paired-sample t-test was used to analyze the sagittal parameters and HRQoL scores of patients with lumbar spondylolisthesis before and at the last follow-up.The Pearson test for the improvement of the sagittal sequence of the spine was associated with the improvement of HRQoL score.Sexuality,and further analysis of multiple independent sagittal parameters to improve HRQoL scores by multiple stepwise regression.Results: A total of 25 cases of lumbar spondylolisthesis(7 males and 18females)were included.The basic condition was 162.1 ± 6.2 cm in height,28.4 ± 4.3months in follow-up,57 ± 9.2 years old,and 62.4 ± 9.9 kg.Paired sample t-test results showed that SS(P = 0.01),PT(P < 0.001),that is,patients with complete reduction of lumbar spondylolisthesis had significant changes in the sagittalsequence before and after surgery.Compared with preoperative,patients with lumbar spondylolisthesis The HRQoL scores of SF-36 PCS,SRS-22,and ODI were significantly different at the last follow-up(P < 0.001).Pearson's test found that the sagittal parameters of the HRQoL were TIA,TPA,LL and PT.Multivariate stepwise regression test showed that PT was an independent correlation sagittal parameter for improving HRQoL: PT(r = 0.726)was positively correlated with ODI;PT was negatively correlated with SF-36 PCS(r =-0.842)and SRS-22(r =-0.924).Conclusion:Lumbar spondylolisthesis can effectively reconstruct the patient's spinal sagittal sequence and improve the patient's HRQoL.PT is an independent related sagittal parameter that improves HRQoL.