Olivier Gille1, Houssam Bouloussa1, Simon Mazas1, Claudio Vergari2, Vincent Challier1, Jean-Marc Vital1, Pierre Coudert1, Soufiane Ghailane3. 1. Department of Spinal Surgery Unit 1, C.H.U Tripode Pellegrin, Bordeaux University Hospital, Université de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France. 2. School of Physics and Astronomy, University of Exeter, Exeter, UK. 3. Department of Spinal Surgery Unit 1, C.H.U Tripode Pellegrin, Bordeaux University Hospital, Université de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France. soufiane.ghailane@gmail.com.
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.
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.
Authors: Aaron J Buckland; Shaleen Vira; Jonathan H Oren; Renaud Lafage; Bradley Y Harris; Matthew A Spiegel; Bassel G Diebo; Barthelemy Liabaud; Themistocles S Protopsaltis; Frank J Schwab; Virginie Lafage; Thomas J Errico; John A Bendo Journal: Spine J Date: 2016-04-05 Impact factor: 4.166
Authors: Frank J Schwab; Benjamin Blondel; Shay Bess; Richard Hostin; Christopher I Shaffrey; Justin S Smith; Oheneba Boachie-Adjei; Douglas C Burton; Behrooz A Akbarnia; Gregory M Mundis; Christopher P Ames; Khaled Kebaish; Robert A Hart; Jean-Pierre Farcy; Virginie Lafage Journal: Spine (Phila Pa 1976) Date: 2013-06-01 Impact factor: 3.468
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