Correlation Analysis Of Multiple-Level Lumbar Spondylolysis With Spinal-pelvic Sagittal Parameters And Its Clinical Characteristics

Objective:?This study was performed to explore the correlation of spinal-pelvic sagittal parameters in asymptomatic populations in China and the related factors affecting the spinal-pelvic sagittal balance.We explored the regression equation that could predict the spine-pelvic sagittal balance.?We also analyzed the correlation among the spinal-pelvic sagittal parameters of patients with lumbar spondylolysis(including single-level and multiple-level).?To investigate the sagittal Mechanisms of decompensation in single-level and multiple-level spondylolysis And which parameters are related to the decompensation of spinal-pelvic sagittal balance,the facts Cause the occurrence and development of spondylolysis and spondylolisthesis.Methods:This retrospective analysis included 41 cases of multiple-level spondylolysis and 46 patients with single-level spondylolysis in the hospital from 2014 to 2018.This thesis also included 124 volunteers without any spine-related diseases.We compared the following difference among three groups,including gender,height,weight,age,main symptoms,the segment of spondylolysis,the degree of spondy lolisthesis,the segment of spondylolisthesis,Pelvic Incidence angle(PI),pelvic tilt angle(PT),lumbar lordosis(LL),sacrum slop(SS),thoracic kyphosis(TK),sagittal vertical axis(SVA),T1 pelvic angle(TPA),T1 tilt angle(T1S),and pelvic angle(PA).We compared the demographic data and sagittal imaging data of the three groups and analyzed every parameter with a statistical description.the Pearson Correlation Test was used to analyzes the correlation of various parameters,and the multiple linear regression was used to explores the equation that predicts the sagittal balance of normal people,One-way analysis of variance was used to analyze the difference of sagittal parameters among normal three groups.Results:There were differences in PI values between male and female volunteers in the normal group.We found the value of females were larger than the value of males.Besides,in the normal group,PI was related to PT,LL,SS,PA,TPA.And PT correlated with SVA,PA,TPA.LL was related to SS and TK.There is a correlation between TK and T1S,SVA and T1S,and PA and TPA,p<0.05.The Sagittal balance could be predicted by the following regression equation:SVA=0.116*T1S-0.261*LL+0.264*SS+0.081*TK+ 0.052*PI-4.687.Among 41 patients with multiple-level spondylolysis,we found that 35 patients with spondylolysis at L4,L5;2 patients at L3,L4,L5;2 patients at L3,L4;2 patients at L3,L5;and one patient with spondylolysis at L2 and L5.In the multiple-level group,PI was related to PT,LL,SS,and TPA;PT was related to SVA,PA,and TPA;LL was related to SS and SVA;There is a correlation between TK and T1S,SVA and TPA,and PA and TPA.The correlation among the spinal-pelvic sagittal parameters of single-level spondylolysis is similar to multiple-level spondylolysis.We found the significant statistical difference of the PT,SS,PA,and TPA between the normal group and the spondylolysis group,while the single-level group and multiple-level group were found no significant difference.There were significant differences in PI and SVA between the three groups,and the relationships were multiple-level>single-level>normal.There were no significant differences in LL among the three groups.Conclusion:There were differences in PI values between men and women in the normal Chinese group,and the values of women were larger than men.The sagittal balance could be predicted by the following regression equation:SVA=0.116*T1S-0.261*LL+0.264*SS+0.081*TK+0.052*PI-4.687,And guide lumbar spine surgery through it.multiple-level spondylolysis was more common in the middle-aged female group.The multiple-level.spondylolysis was most common in lower lumber.The clinical symptoms of multiple-level spondylolysis were similar to those of single-level spondylolysis.The increase of SVA and PI were closely related to the occurrence of multiple-level spondylolysis.Increased values of PT,SS,PA,and TPA were associated with the occurrence of lumbar spondylolysis.The values of LL could be maintained in single-level and multiple-level spondylolysis,and it is involved in the regulation of the decompensated balance of spondylolysis,which may lead to the occurrence of multisegment spondylolysis.