Labbus Kirsten, Bürger Justus, Löchel Jannis, Schäfer Frederik Maximilian, Putzier Michael, Zahn Robert Karl
Center for Musculoskeletal Surgery (CMSC), Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Universitätsmedizin Berlin, Berlin, Germany.
Institute for Radiology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Universitätsmedizin Berlin, Berlin, Germany.
Global Spine J. 2024 Nov;14(8):2311-2316. doi: 10.1177/21925682231178206. Epub 2023 Jun 7.
Retrospective analysis of prospectively collected data.
Isthmic spondylolisthesis (iSPL) occurs most commonly in L5/S1 and L4/5. This study investigates the association between spinopelvic anatomy and the pathogenesis of iSPL.
Spinopelvic parameters as well as severity of slip grade were measured in sagittal spine radiographs of symptomatic patients with iSPL in segments L4/5 and L5/S1. Means were calculated and differences between both groups were analyzed. A correlation between the analyzed parameters and degree of slippage was performed.
We included 73 subjects in this study; 11 in L4/5 group and 62 in L5/S1 group. Pelvic anatomy significantly differed between L4/5 and L5/S1 iSPL (Pelvic Incidence (PI) 54.8° vs 66.3°, value = .006; Pelvic Radius (PR) 124.4 mm vs 137.4 mm; value = .005 and Sacral Table Angle (STA) 101.0° vs 92.2°, value < .001). The relative degree of slippage was significantly higher in the L5/S1 group (L4/5 29.1% vs L5/S1 40.1%, value .022). We also observed a significant correlation between pelvic anatomy and the severity of the slip in iSPL at the L5/S1 level.
Pelvic parameters PI and STA play an important role concerning the level of occurrence and severity of iSPL. Spinopelvic anatomy determines the pathogenesis of iSPL.
对前瞻性收集的数据进行回顾性分析。
峡部裂性腰椎滑脱症（iSPL）最常发生于L5/S1和L4/5节段。本研究旨在探讨脊柱骨盆解剖结构与iSPL发病机制之间的关联。
在L4/5和L5/S1节段有症状的iSPL患者的矢状位脊柱X线片上测量脊柱骨盆参数以及滑脱分级的严重程度。计算平均值并分析两组之间的差异。对分析参数与滑脱程度进行相关性分析。
本研究纳入73名受试者；L4/5组11名，L5/S1组62名。L4/5和L5/S1的iSPL患者骨盆解剖结构存在显著差异（骨盆入射角（PI）54.8°对66.3°，P值 = 0.006；骨盆半径（PR）124.4 mm对137.4 mm，P值 = 0.005；骶骨平台角（STA）101.0°对92.2°，P值 < 0.001）。L5/S1组的相对滑脱程度显著更高（L4/5为29.1%对L5/S1为40.1%，P值 = 0.022）。我们还观察到在L5/S1水平，骨盆解剖结构与iSPL的滑脱严重程度之间存在显著相关性。
骨盆参数PI和STA在iSPL的发生节段和严重程度方面起着重要作用。脊柱骨盆解剖结构决定了iSPL的发病机制。
