nach oben

European Spine Journal

Erschienen in:

01.06.2015 | Original Article

Pelvic retroversion is the key protective mechanism of L4–5 degenerative spondylolisthesis

verfasst von: Hui Liu, Sibei Li, Zhaomin Zheng, Jiranru Wang, Huafeng Wang, Xiang Li

Erschienen in: European Spine Journal | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To explore the role of spinopelvic sagittal alignment in the pathological mechanism of degenerative spondlylolisthesis (DS) development.

Method

A total of 52 asymptomatic volunteers, 32 single segment L4–5 DS and 29 lumbar spinal stenosis (LSS) without spondylolisthesis patients were enrolled. All subjects had standard lumbar spine X-ray films with standard position along with lumbar spine magnetic resonance image. Comparative analysis of sagittal parameters and disc degeneration grades among asymptomatic volunteers and patients with the two disorders were performed.

Results

Compared to normal population (NP) and LSS, DS showed significantly greater pelvic incidence (PI), sacral slope (SS) and lumbar lordosis (LL), while LSS showed significantly smaller PT and PT/SS. DS showed significantly greater L5 slope than NP and LSS. In both Great-PI group and Small-PI group, all above differences between DS and LSS remained. LSS showed significantly higher degenerative grade of each adjacent disc than DS. Population with adjacent segment degeneration showed higher incidence of pelvic retroversion (PT/SS ≥1), and LSS showed greater proportion of adjacent segment degeneration than DS.

Conclusions

Lumbar spine morphology of great LL determined by great PI is a risk factor of L4–5 DS. L5 slope is a parameter that can be used to predict the risk of L4–5 DS. Pelvic retroversion is the key protective mechanism from DS. Adjacent segment degeneration is a driving factor of pelvic retroversion for compensation of lumbar sagittal malalignment.

Nur mit Berechtigung zugänglich

Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson AN, Blood EA, Birkmeyer NJ, Hilibrand AS, Herkowitz H, Cammisa FP, Albert TJ, Emery SE, Lenke LG, Abdu WA, Longley M, Errico TJ, Hu SS (2007) Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med 356:2257–2270CrossRefPubMedCentralPubMed

Smorgick Y, Park DK, Baker KC, Lurie JD, Tosteson TD, Zhao W, Herkowitz HN, Fischgrund JS, Weinstein JN (2013) Single- versus multilevel fusion for single-level degenerative spondylolisthesis and multilevel lumbar stenosis: four-year results of the spine patient outcomes research trial. Spine Phila Pa 1976 38:797–805CrossRefPubMedCentralPubMed

Schuller S, Charles YP, Steib JP (2010) Sagittal spinopelvic alignment and body mass index in patients with degenerative spondylolisthesis. Eur Spine J 20:713–719CrossRefPubMedCentralPubMed

Fujiwara A, Tamai K, Yamato M, An HS, Yoshida H, Saotome K, Kurihashi A (1999) The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study. Eur Spine J 8:396–401CrossRefPubMedCentralPubMed

Devine JG, Schenk-Kisser JM, Skelly AC (2012) Risk factors for degenerative spondylolisthesis: a systematic review. Evid Based Spine Care J 3:25–34CrossRefPubMedCentralPubMed

Mariconda M, Galasso O, Imbimbo L, Lotti G, Milano C (2007) Relationship between alterations of the lumbar spine, visualized with magnetic resonance imaging, and occupational variables. Eur Spine J 16:255–266CrossRefPubMedCentralPubMed

Berlemann U, Jeszenszky DJ, Buhler DW, Harms J (1999) The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. J Spinal Disord 12:68–73CrossRefPubMed

Berlemann U, Jeszenszky DJ, Buhler DW, Harms J (1999) Mechanisms of retrolisthesis in the lower lumbar spine: a radiographic study. Acta Orthop Belg 65:472–477PubMed

Boden SD, Riew KD, Yamaguchi K, Branch TP, Schellinger D, Wiesel SW (1996) Orientation of the lumbar facet joints: association with degenerative disc disease. J Bone Joint Surg Am 78:403–411PubMed

10.

Matsunaga S, Sakou T, Morizono Y, Masuda A, Demirtas AM (1990) Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage. Spine 15:1204–1210 Phila Pa 1976CrossRefPubMed

11.

Roussouly P, Pinheiro-Franco JL (2011) Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J 20(Suppl 5):609–618CrossRefPubMedCentralPubMed

12.

Schwab FJ, Blondel B, Bess S, Hostin R, Shaffrey CI, Smith JS, Boachie-Adjei O, Burton DC, Akbarnia BA, Mundis GM, Ames CP, Kebaish K, Hart RA, Farcy JP, Lafage V (2013) Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine 38:E803–E812 Phila Pa 1976CrossRefPubMed

13.

Le Huec JC, Charosky S, Barrey C, Rigal J, Aunoble S (2011) Sagittal imbalance cascade for simple degenerative spine and consequences: algorithm of decision for appropriate treatment. Eur Spine J 20(Suppl 5):699–703CrossRefPubMedCentralPubMed

14.

Barrey C, Jund J, Noseda O, Roussouly P (2007) Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases: a comparative study about 85 cases. Eur Spine J 16:1459–1467CrossRefPubMedCentralPubMed

15.

Schwab FJ, Smith VA, Biserni M, Gamez L, Farcy JP, Pagala M (2002) Adult scoliosis: a quantitative radiographic and clinical analysis. Spine 27:387–392 Phila Pa 1976CrossRefPubMed

16.

Terran J, Schwab F, Shaffrey CI, Smith JS, Devos P, Ames CP, Fu KM, Burton D, Hostin R, Klineberg E, Gupta M, Deviren V, Mundis G, Hart R, Bess S, Lafage V (2013) The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort. Neurosurgery 73:559–568CrossRefPubMed

17.

Smith JS, Klineberg E, Schwab F, Shaffrey CI, Moal B, Ames CP, Hostin R, Fu KM, Burton D, Akbarnia B, Gupta M, Hart R, Bess S, Lafage V (2013) Change in classification grade by the SRS-Schwab adult spinal deformity classification predicts impact on health-related quality of life measures: prospective analysis of operative and non-operative treatment. Spine Phila Pa 1976. doi:10.1097/BRS.0b013e31829ec563

18.

Schwab F, Lafage V, Patel A, Farcy JP (2009) Sagittal plane considerations and the pelvis in the adult patient. Spine Phila Pa 1976 34:1828–1833CrossRefPubMed

19.

Lee JH, Kim KT, Suk KS, Lee SH, Jeong BO, Kim JS, Eoh JH, Kim YJ (2010) Analysis of spinopelvic parameters in lumbar degenerative kyphosis: correlation with spinal stenosis and spondylolisthesis. Spine 35:E1386–E1391 Phila Pa 1976CrossRefPubMed

20.

Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O’Brien M (2005) The importance of spino-pelvic balance in L5-s1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine 30:S27–S34 Phila Pa 1976CrossRefPubMed

21.

Kim MK, Lee SH, Kim ES, Eoh W, Chung SS, Lee CS (2011) The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: a pilot study. BMC Musculoskelet Disord 12:69CrossRefPubMedCentralPubMed

22.

Huang KY, Lin RM, Lee YL, Li JD (2009) Factors affecting disability and physical function in degenerative lumbar spondylolisthesis of L4-5: evaluation with axially loaded MRI. Eur Spine J 18:1851–1857CrossRefPubMedCentralPubMed

23.

Morvan G, Mathieu P, Vuillemin V, Guerini H, Bossard P, Zeitoun F, Wybier M (2011) Standardized way for imaging of the sagittal spinal balance. Eur Spine J 20(Suppl 5):602–608CrossRefPubMedCentralPubMed

24.

Funao H, Tsuji T, Hosogane N, Watanabe K, Ishii K, Nakamura M, Chiba K, Toyama Y, Matsumoto M (2012) Comparative study of spinopelvic sagittal alignment between patients with and without degenerative spondylolisthesis. Eur Spine J 21:2181–2187CrossRefPubMedCentralPubMed

25.

Berthonnaud E, Dimnet J, Roussouly P, Labelle H (2005) Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech 18:40–47CrossRefPubMed

26.

Been E, Barash A, Pessah H, Peleg S (2010) A new look at the geometry of the lumbar spine. Spine 35:E1014–E1017 Phila Pa 1976CrossRefPubMed

27.

Been E, Li L, Hunter DJ, Kalichman L (2011) Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study. Eur Spine J 20:1159–1165CrossRefPubMedCentralPubMed

28.

Vrtovec T, Janssen MM, Likar B, Castelein RM, Viergever MA, Pernus F (2012) A review of methods for evaluating the quantitative parameters of sagittal pelvic alignment. Spine J 12:433–446CrossRefPubMed

29.

Miao J, Wang S, Park WM, Xia Q, Fang X, Torriani MP, Wood KB, Li G (2013) Segmental spinal canal volume in patients with degenerative spondylolisthesis. Spine J 13:706–712CrossRefPubMedCentralPubMed

30.

Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26:1873–1878 Phila Pa 1976CrossRefPubMed

31.

Lee JC, Cha JG, Yoo JH, Kim HK, Kim HJ, Shin BJ (2012) Radiographic grading of facet degeneration, is it reliable?: a comparison of MR or CT grading with histologic grading in lumbar fusion candidates. Spine J 12:507–514CrossRefPubMed

32.

Toyone T, Ozawa T, Kamikawa K, Watanabe A, Matsuki K, Yamashita T, Wada Y (2009) Facet joint orientation difference between cephalad and caudad portions: a possible cause of degenerative spondylolisthesis. Spine 34:2259–2262 Phila Pa 1976CrossRefPubMed

33.

Mac-Thiong JM, Wang Z, de Guise JA, Labelle H (2008) Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis. Spine 33:2316–2325 Phila Pa 1976CrossRefPubMed

34.

Labelle H, Roussouly P, Chopin D, Berthonnaud E, Hresko T, O’Brien M (2008) Spino-pelvic alignment after surgical correction for developmental spondylolisthesis. Eur Spine J 17:1170–1176CrossRefPubMedCentralPubMed

35.

Roussouly P, Gollogly S, Berthonnaud E, Labelle H, Weidenbaum M (2006) Sagittal alignment of the spine and pelvis in the presence of L5-s1 isthmic lysis and low-grade spondylolisthesis. Spine 31:2484–2490 Phila Pa 1976CrossRefPubMed

36.

Vialle R, Ilharreborde B, Dauzac C, Lenoir T, Rillardon L, Guigui P (2007) Is there a sagittal imbalance of the spine in isthmic spondylolisthesis?: a correlation study. Eur Spine J 16:1641–1649CrossRefPubMedCentralPubMed

37.

Boulay C, Tardieu C, Hecquet J, Benaim C, Mouilleseaux B, Marty C, Prat-Pradal D, Legaye J, Duval-Beaupere G, Pelissier J (2006) Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J 15:415–422CrossRefPubMedCentralPubMed

38.

Vaz G, Roussouly P, Berthonnaud E, Dimnet J (2002) Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J 11:80–87CrossRefPubMedCentralPubMed

39.

Roussouly P, Pinheiro-Franco JL (2011) Sagittal parameters of the spine: biomechanical approach. Eur Spine J 20(Suppl 5):578–585CrossRefPubMedCentralPubMed

40.

Roussouly P, Gollogly S, Berthonnaud E, Dimnet J (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine 30:346–353 Phila Pa 1976CrossRefPubMed

41.

Barrey C, Roussouly P, Perrin G, Le Huec JC (2011) Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? Eur Spine J 20(Suppl 5):626–633CrossRefPubMedCentralPubMed

42.

Keller TS, Colloca CJ, Harrison DE, Harrison DD, Janik TJ (2005) Influence of spine morphology on intervertebral disc loads and stresses in asymptomatic adults: implications for the ideal spine. Spine J 5:297–309CrossRefPubMed

43.

Jacobsen S, Sonne-Holm S, Rovsing H, Monrad H, Gebuhr P (2007) Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen osteoarthritis study. Spine 32:120–125 Phila Pa 1976CrossRefPubMed

44.

Mac-Thiong JM, Roussouly P, Berthonnaud E, Guigui P (2011) Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults. Eur Spine J 20(Suppl 5):572–577CrossRefPubMedCentralPubMed

Titel: Pelvic retroversion is the key protective mechanism of L4–5 degenerative spondylolisthesis
verfasst von: Hui Liu
Sibei Li
Zhaomin Zheng
Jiranru Wang
Huafeng Wang
Xiang Li
Publikationsdatum: 01.06.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 6/2015
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3395-7

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Pelvic retroversion is the key protective mechanism of L4–5 degenerative spondylolisthesis

Abstract

Purpose

Method

Results

Conclusions

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Zwei neue Alternativen zu TNF-Inhibitoren bei axSpA

Update Orthopädie und Unfallchirurgie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Method

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2015

Lumbo-pelvic related indexes: impact on adult spinal deformity surgery

Expert’s comment concerning Grand Rounds case entitled “Solid aneurysmal bone cyst on the cervical spine of a young child” (L. Casabianca et al.)

Pelvic incidence and pelvic tilt measurements using femoral heads or acetabular domes to identify centers of the hips: comparison of two methods

The effect of growing rod lengthening technique on the sagittal spinal and the spinopelvic parameters

Sagittal spinopelvic alignment in 654 degenerative spondylolisthesis

Core outcome domains for clinical trials in non-specific low back pain

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Zwei neue Alternativen zu TNF-Inhibitoren bei axSpA

Update Orthopädie und Unfallchirurgie