He Baoqiang, Leng Yebo, Xu Shicai, Li Yang, Zhou Jiajun, Kang Min, Liao Yehui, Tian Minghao, Tang Qiang, Ma Fei, Wang Qing, Tang Chao, Zhong Dejun
Department of Orthopedics, The Affiliated Hospital, Southwest Medical University, Luzhou, China.
Department of Spine Surgery, Suining Central Hospital, Suining, China.
Neurospine. 2025 Mar;22(1):231-242. doi: 10.14245/ns.2448900.450. Epub 2025 Mar 31.
Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed.
This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5-S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4-5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed.
Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA.
This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.
基于脊柱骨盆参数和生物力学原理,分析峡部裂性和退变性腰椎滑脱的椎弓根-小关节(PFJ)形态学特征,并探讨其发病及进展机制。
这项回顾性横断面研究纳入了194例L5峡部裂或L5-S1低度峡部裂性腰椎滑脱患者(IS组)、172例L4-5退变性腰椎滑脱患者(DS组)和366例非腰椎峡部裂患者(NL组)。测量患者的脊柱骨盆参数和PFJ形态学参数,比较3组间及组内这些参数的差异,并分析相关性。
骶骨倾斜角(SS)和腰椎前凸角(LL)在IS组最高,DS组次之,NL组最低。3组中,L4小关节角(FJA)在IS组最大,NL组次之,DS组最小。L4椎弓根-小关节角(PFA)在DS组最大,IS组次之,NL组最小。Pearson相关性分析显示,在每组内,SS和LL与FJA呈负相关,与PFA呈正相关。
本研究发现腰椎滑脱患者的PFJ形态学特征与脊柱骨盆参数之间存在相关性,提示PFJ的形态学特征可能是由不同脊柱骨盆形态下的应力变化所致。