Assessment of sagittal spinopelvic parameters in a Taiwanese population with spondylolysis by the EOS imaging system: a retrospective radiological analysis

Abstract

Background The impact of sagittal spinopelvic alignment on spondylolysis is well established in Caucasian populations. However, prior studies suggest that people from different ethnological backgrounds showed divergence, and a few studies that focused on Asian populations reported conflicting results. The aim of this study is to use the EOS imaging system to evaluate the spinopelvic parameters of spondylolysis patients, and their relationship with spondylolisthesis, disc degeneration, and age in a Taiwanese population. Methods Radiographic sagittal spinopelvic parameters for 45 spondylolysis patients and 32 healthy people were evaluated, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), thoracic kyphosis (TK), and lumbar lordosis (LL). The spinopelvic parameters were compared between spondylolytic and control groups. These parameters were further compared between spondylolytic subjects with and without spondylolisthesis, with and without high-grade disc degeneration, and young (< 30 years old) and middle-aged. Results The PI and LL of the spondylolytic group (52.6°±12.0° and 41.3°±15.2°) were significantly higher than those of the healthy control group (47.16°±7.95° and 28.22°±10.65°). Further analysis of the spondylolytic patients revealed that those with high-grade disc degeneration were more prone to spondylolisthesis (92.3 %) compared to those without (50 %; p = 0.001). The middle-aged group had significantly higher rates of spondylolisthesis (80 %) and high-grade disc degeneration (52.4 %) compared with those for the young group (45 and 16.7 %, respectively; p = 0.017 and 0.047, respectively). No statistically significant difference in the sagittal spinopelvic parameters was found when spondylolytic patients were divided according to the occurrence of spondylolisthesis or high-grade disc degeneration. Conclusions In a Taiwanese population, PI and LL were significantly larger in spondylolytic patients. Disc degeneration and age were associated with the occurrence of spondylolisthesis. Ethnological differences should thus be taken into account when making clinical decisions regarding spondylolysis in a Taiwanese population.

The Importance of Spinopelvic Parameters in Recurrent Lumbar Disk Herniation

“…The difference in ST values is thought to be due to social anatomic differences. In the literature, spinopelvic parameters do not show similarity in different populations 23–25 …”

“…In the literature, spinopelvic parameters do not show similarity in different populations. [23][24][25] The lower lumbar region and the lumbosacral junction is generally considered the most critical and complex spine region. For a more accessible and better understanding of this region, Roussouly et al 6 classified normal variations of the lumbar region and pelvis in the sagittal plane into 4 types.…”

Associations between femoral 3D curvature and sagittal imbalance of spine

“…During the scan, subjects were asked to maintain a standardized free standing position with the shoulder and elbow anteriorly flexed and hands rested on the mandibles and a shifted feet position, as proposed by Chaibi et al 10 This allowed the examination of the spine and lower limbs under normal weight‐bearing conditions. In addition, true‐to‐size images were obtained as the system employed the detection of two orthogonally co‐linked and collimated linear X‐ray beam 11,12 …”

“…Lumbar lordosis (LL): the angle between the superior L1 and sacral endplates. Pelvic incidence (PI): the angle between a line perpendicular to the sacral plate and the line connecting the midpoint of the sacral plate to the CFH 11,16 Pelvic tilt (PT): the angle between a vertical line and the line connecting the midpoint of the sacral plate to the CFH 11,16 Sacral slope (SS): the angle between the horizontal line and the sacral plate 16 …”

“…In addition, true‐to‐size images were obtained as the system employed the detection of two orthogonally co‐linked and collimated linear X‐ray beam. 11 , 12 …”