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23.08.2017 | Original Article | Ausgabe 12/2017

European Spine Journal 12/2017

A new classification system for degenerative spondylolisthesis of the lumbar spine

Zeitschrift:
European Spine Journal > Ausgabe 12/2017
Autoren:
Olivier Gille, Houssam Bouloussa, Simon Mazas, Claudio Vergari, Vincent Challier, Jean-Marc Vital, Pierre Coudert, Soufiane Ghailane
Wichtige Hinweise
Oral communication at the SICOT (International Society of Orthopaedic Surgery and Traumatology), annual meeting in Roma, Italy, September 8, 2016. Abstract no. 43858.
Oral communication in IMAST annual meeting in Cape Town, South Africa, July 14, 2017.

Abstract

Purpose

There is no consensus for a comprehensive analysis of degenerative spondylolisthesis of the lumbar spine (DSLS). A new classification system for DSLS based on sagittal alignment was proposed. Its clinical relevance was explored.

Methods

Health-related quality-of-life scales (HRQOLs) and clinical parameters were collected: SF-12, ODI, and low back and leg pain visual analog scales (BP-VAS, LP-VAS). Radiographic analysis included Meyerding grading and sagittal parameters: segmental lordosis (SL), L1–S1 lumbar lordosis (LL), T1–T12 thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis (SVA). Patients were classified according to three main types—1A: preserved LL and SL; 1B: preserved LL and reduced SL (≤5°); 2A: PI–LL ≥10° without pelvic compensation (PT < 25°); 2B: PI–LL ≥10° with pelvic compensation (PT ≥ 25°); type 3: global sagittal malalignment (SVA ≥40 mm).

Results

166 patients (119 F: 47 M) suffering from DSLS were included. Mean age was 67.1 ± 11 years. DSLS demographics were, respectively: type 1A: 73 patients, type 1B: 3, type 2A: 8, type 2B: 22, and type 3: 60. Meyerding grading was: grade 1 (n = 124); grade 2 (n = 24). Affected levels were: L4–L5 (n = 121), L3–L4 (n = 34), L2–L3 (n = 6), and L5–S1 (n = 5). Mean sagittal parameter values were: PI: 59.3° ± 11.9°; PT: 24.3° ± 7.6°; SVA: 29.1 ± 42.2 mm; SL: 18.2° ± 8.1°. DSLS types were correlated with age, ODI and SF-12 PCS (ρ = 0.34, p < 0.05; ρ = 0.33, p < 0.05; ρ = −0.20, and p = 0.01, respectively).

Conclusion

This classification was consistent with age and HRQOLs and could be a preoperative assessment tool. Its therapeutic impact has yet to be validated.

Level of evidence

4.

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