Sagittal spinopelvic alignment in 654 degenerative spondylolisthesis

Area of Science:

• Spine surgery
• Orthopedics
• Radiology

Background:

• Degenerative spondylolisthesis (DS) is a prevalent spinal condition.
• Spinopelvic alignment significantly influences clinical outcomes in DS.
• High pelvic incidence (PI) has been linked to DS development.

Purpose of the Study:

• To characterize epidemiologic and sagittal spinopelvic parameters in DS patients.
• To compare these parameters with asymptomatic volunteers.
• To develop a classification system for DS patients.

Main Methods:

• Retrospective multicenter study of prospectively collected data.
• Inclusion of adult patients treated for lumbar DS.
• Radiographic assessment of PI, pelvic tilt (PT), maximal lumbar lordosis (LLmax), and C7tilt, compared to 709 controls.
• Cluster analysis for patient classification.

Main Results:

• 654 DS patients (72% female, mean age 67) exhibited higher PI and C7tilt compared to controls.
• DS patients showed significantly reduced LLmax and lumbosacral lordosis.
• Cluster analysis identified two main groups based on C7tilt, with further subgroups revealing variations in PI and spinopelvic parameters.

Conclusions:

• High PI and female gender are predominant in the DS population.
• Sagittal malalignment, including anterior C7tilt and pelvic retroversion, is common in DS.
• Personalized surgical correction strategies are recommended for DS subgroups based on malalignment.