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Pelvic lordosis and alignment in spondylolisthesis
Roger P Jackson1, Timothy Phipps, Chris Hales
1Spine Surgery Service, North Kansas City Hospital, North Kansas City, Missouri, USA. rogerjackson@attglobal.net
Spine
|January 25, 2003
Summary
Pelvic morphology and lumbopelvic lordosis differ significantly in patients with spondylolisthesis compared to healthy individuals. Smaller pelvic lordosis angles correlate with increased spondylolisthesis severity, suggesting a role for pelvic structure in its development.
Area of Science:
- Orthopedics
- Radiology
- Spine Surgery
Background:
- The exact causes of isthmic (lytic) spondylolisthesis are not fully understood and appear to be multifactorial.
- Further investigation into the relationship between pelvic morphology and the development of spondylolisthesis is warranted.
Purpose of the Study:
- To compare pelvic morphology and lumbopelvic lordosis in patients with L5-S1 spondylolytic spondylolisthesis versus healthy volunteers.
- To determine significant differences in radiographic measurements between these two groups.
Main Methods:
- Standing lateral radiographs of the thoracolumbar spine and pelvis were obtained for 75 patients with spondylolisthesis and 75 controls.
- Three radiographic angles measuring pelvic morphology (pelvisacral, pelvic incidence, and pelvic lordosis) were assessed.
- Lumbar lordosis and lumbopelvic lordosis were calculated to evaluate the combined contribution to spinal curvature.
Main Results:
- Patients with spondylolisthesis exhibited significant differences in lumbar lordosis, pelvic lordosis, and lumbopelvic lordosis compared to controls (P < 0.01).
- A significant inverse correlation was observed between the severity of spondylolisthesis (Grade I-III) and the mean pelvic lordosis angle.
- Mean slippage in the patient group was 30%, with varying degrees of slip observed.
Conclusions:
- Distinct differences in pelvic and lumbopelvic parameters exist between patients with spondylolisthesis and controls.
- Reduced pelvic contribution to lordosis is associated with higher grades of spondylolisthesis.
- Pelvic morphology may be a contributing factor in the pathogenesis of spondylolisthesis, highlighting the importance of assessing lumbopelvic lordosis.
