Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, P.R. China.
Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, P.R. China.
World Neurosurg. 2022 Aug;164:e150-e156. doi: 10.1016/j.wneu.2022.04.063. Epub 2022 Apr 22.
The features of lumbar curves in patients with lumbar spondylolisthesis (LS) are unclear. The aim of this retrospective study was to present the clinical and radiologic characteristics of scoliosis due to LS and LS concurrent with main thoracolumbar/lumbar adolescent idiopathic scoliosis (AIS).
This study was conducted as a single-center retrospective comparative study on 56 pediatric spondylolisthesis patients with main thoracolumbar/lumbar curves. Cases were divided into 2 groups according to the course of scoliosis after spinal surgery of LS. Sagittal spinopelvic parameters and scoliotic characteristics were compared between the 2 groups.
The prevalence of scoliosis was 15.3% in pediatric LS patients in our study population. Lumbar lordosis (LL), Cobb angle, apical rotation, and coronal deformity angular ratio (C-DAR) were higher in the LS concurrent with AIS group than in the LS with functional scoliosis group (P < 0.05), while curve span, apical vertebral translation, and central sacral vertical line to C7 plumb line were lower (P < 0.05). Logistic regression analyses and receiver operating characteristic curves showed that LL and C-DAR were significant risk factors of unresolved lumbar curves after spinal surgery for LS, with a cutoff value of 51.5°and 3.5, respectively.
Lumbar scoliosis may develop due to LS, or a concurrent condition to LS. LL and C-DAR are the features that differentiate AIS from functional scoliosis in patients with LS.
腰椎滑脱症（LS）患者的腰椎曲线特征尚不清楚。本回顾性研究旨在介绍 LS 伴或不伴主胸腰/腰椎青少年特发性脊柱侧凸（AIS）的脊柱侧凸的临床和影像学特征。
本研究为单中心回顾性对照研究，纳入 56 例主胸腰/腰椎曲线存在的小儿 LS 患者。根据 LS 脊柱手术后脊柱侧凸的病程，将病例分为 2 组。比较两组矢状位脊柱骨盆参数和脊柱侧凸特征。
在本研究人群中，小儿 LS 患者脊柱侧凸的患病率为 15.3%。LS 合并 AIS 组的腰椎前凸（LL）、Cobb 角、顶椎旋转和冠状面畸形角比值（C-DAR）均高于 LS 伴功能性脊柱侧凸组（P < 0.05），而曲线跨度、顶椎椎体平移和骶骨中轴与 C7 铅垂线的距离则较低（P < 0.05）。Logistic 回归分析和受试者工作特征曲线显示，LL 和 C-DAR 是 LS 脊柱手术后腰椎曲线未解决的显著危险因素，截断值分别为 51.5°和 3.5。
腰椎滑脱可能是由于 LS 或 LS 的并发情况引起的。LL 和 C-DAR 是 LS 患者中 AIS 与功能性脊柱侧凸的区别特征。
