The Analysis Of The Anatomical Parameters In The Occurrence Of Isthmic And Degenerative Lumbar Spondylolisthesis

Objectives:To analyse the characteristics of anatomical parameters between isthmic and degenerative lumbar spondylolisthesis.To explore the risk factors of lumbar spondylolisthesis.To evaluate the differences of compensatory mechanisms between isthmic and degenerative lumbar spondylolisthesis.Methods:A retrospective study was made on complete imaging data of 87 patients with single L4 lumbar spondylolisthesis,which ranged from September 2017 to June2019.There were 57 females and 30 males,aged 38-74years(mean,57.94±8.74years).According to Meyerding degree,there were 65 cases of grade I,22 cases of grade II.There were 63 cases in degenerative group and 24 cases in isthmic group.Meanwhile,enrolled 93 cases aged and sex-matched normal adults as the control group.There were 40 males and 53 females,aged 23-75years(mean,57.29±8.41years).disc height(DH),lumbar index(LI),spondy slip angle(SSA),sacral horizontal angle(SHA),lumber lordosis angle(LLA)were analyzed on the supine lateral X-ray images of lumbar spine and the length of transverse process of L5(TPL),the width of transverse process of L5(TPW)were determined on the anterior-posterior X-ray images of lumbar spine.Based on the Independent–samples T test,the difference in anatomical factors between LS group and control group was analyzed,the difference in anatomical factors between DS group and IS group was evaluated.Logistic regression analysis of risk parameters of lumbar spondylolisthesis.Results:DH,LI,SSA,SHA,LLA,TPL,TPW of the degenerative group were 9.49±2.12 mm,0.95±0.06,5.00°±3.33°,34.66°±10.40°,41.42°±12.93°,24.64±4.76 mm,14.11±2.76 mm,and the isthmic group were 8.86±2.78 mm,0.92±0.07,4.83°±3.47°,37.07°±11.14°,46.02°±12.26°,23.84±4.44 mm,13.26±2.33 mm.Meanwhile the parameters in the control groups were 13.08±10.80 mm,0.95±0.08,6.98°±3.74°,34.33°±9.69°,42.25°±12.83°,23.00±4.01 mm,14.29±2.71 mm.SSA,DH had significant difference between DS group and control group(P<0.05).TPL had significant difference between grade I of DS group and control group(P<0.05).DH had significant difference between grade I and II of DS group(P<0.05);LI,SHA,LLA,TPW of the those groups were no significant difference(P>0.05).Logistic regression analysis indicated statistically significant associations between LS and DH,TPL.The regression coefficients of DH and TPL were0.538,-0.103.Conclusions:Changes proposed hat anatomical parameters between the degenerative and isthmic lumbar spondylolisthesis was similar.According to Logistic regression analysis,the decline of DH and the rise of TPL may be the risk factors of LS.Results indicated that compensatory mechanisms between the degenerative and isthmic lumbar spondylolisthesis was similar.