Double-level degenerative spondylolisthesis: what is different in the sagittal plane?

Ferrero, Emmanuelle; Simon, Anne-Laure; Magrino, Baptiste; Ould-Slimane, Mourad; Guigui, P.

doi:10.1007/s00586-016-4384-9

Cited by 16 publications

(16 citation statements)

References 35 publications

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“…In this study, 77.6% of double-level DLS patients were women, which is similar to that obtained by previous studies [18,19]. Previous studies have shown that compared with single-level DLS, women with double-level DLS account for a larger proportion (approximately 70%) [14]. Interestingly, this study found that women in the anterior type accounted for a larger proportion of women in double-level DLS, while men and women had a similar proportion in the combined type group.…”

Section: Discussionsupporting

confidence: 90%

“…The most common level of slippage in single-level DLS patients is L4L5, but the levels of L3L4-L4L5 and L4L5-L5S1 is common in double-level DLS patients [14]. This study found that L3L4-L4L5 and L4L5-L5S1 levels of spondylolisthesis are common in double-level DLS, which is similar to that obtained in previous studies.…”

Section: Discussionsupporting

confidence: 90%

“…The spondylolisthesis distance and sagittal spinopelvic parameters were measured on the full spinal standing lateral position using x-ray projections including the femoral heads. The slippage distance was measured as distance that the superior vertebra slides forward or backward relative to an adjacent inferior vertebra in the sagittal plane [10,14] (Fig. 2A).…”

Section: Data Collectionmentioning

confidence: 99%

“…2A). The sagittal spinopelvic parameters are as follows ( In addition, to evaluate the relationship between the sagittal spinopelvic parameters and PI, we calculated the ratio of LLmax to PI (LLmax/PI) and the ratio of PT to PI (PT/PI), which are the morphological parameters unique to everyone [14].…”

Section: Data Collectionmentioning

confidence: 99%

“…Emmanuelle et al [14] studied the sagittal spinopelvic parameters of double-level and single-level DLS. The results showed that the double-level DLS had larger PI and C7 tilt, and it initiated the compensation mechanism such as forward exion and pelvic retroversion.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of sagittal spinopelvic parameters in different types of double-level degenerative lumbar spondylolisthesis: a retrospective study

Zhang

Deng

et al. 2020

Preprint

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Background Degenerative lumber spondylolisthesis (DLS), a common orthopaedic disease causing low back pain, seriously affects daily life and work. Although sagittal spinopelvic parameters have been studied in single-level DLS patients, investigations into different types of double-level DLS are scarce. This study aims to analyse the demographic and radiological parameters of patients with different types of double-level DLS and compare their differences to provide a reference for guiding surgical treatment and restoring sagittal balance of DLS patients. Methods From January 2014 to January 2020, double-level DLS patients’ records were retrospectively reviewed and divided into three types: anterior, posterior, and combined; the anterior and combined types were studied. Two spin surgeons measured the sagittal spinopelvic parameters: C7 tilt, maximal thoracic kyphosis (TKmax), maximal lumbar lordosis (LLmax), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Following descriptive analysis, demographic and radiographic data were compared between the anterior and combined types. Results Patients in the anterior type group (n = 40) were older (67.68 ± 6.66 vs. 61.72 ± 10.06 years, P = 0.031), and the proportion of females were significantly higher (90% vs. 50%, P = 0.001) than the combined group (n = 18). Both groups had different levels of chronic lower back pain, but the incidence of radiating leg pain and neurogenic claudication was significantly higher in the anterior type. Owestry disability index and visual analogue scale lower back scores were also higher in the anterior type. In the anterior type, C7 tilt (7.14 ± 2.15 vs. 5.41 ± 2.28, P = 0.007), LLmax (50.02 ± 14.76 vs. 36.96 ± 14.56, P = 0.003), PI (68.28 ± 9.16 vs. 55.53 ± 14.19, P < 0.001), PT (28.68 ± 7.31 vs. 19.38 ± 4.70, P < 0.001), and PT/PI (42.45 ± 11.22 vs. 36.04 ± 9.87, P = 0.041) were significantly higher. In the anterior type, PI correlated significantly positively with LLmax (r = 0.59) and SS (r = 0.71). LLmax and SS (r = 0.65) had a positive correlation. PT/PI and SS (r = -0.77) had a negative correlation. In the combined type, PI correlated positively with LLmax (r = 0.61) and SS (r = 0.88), and PT/PI correlated negatively with SS (r = -0.81). Conclusions In patients with double-level DLS, the sagittal spinopelvic parameters differ between the anterior and combined types. PI and LLmax were significantly higher in the anterior type, resulting in compensation by forward flexion and pelvic retroversion. Spinal surgeons should focus on correcting sagittal deformities, relieving postoperative clinical symptoms, and improving quality of life during fusion surgery, which is proven to guarantee long-term surgical results.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Data Collectionmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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