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Risk Factors For the Development of a Mobile Degenerative Spondylolisthesis at L4-L5.

S Grannum1, P A G Torrie1, A Miller1

  • 1Department of Spinal Surgery, Frenchay hospital, North Bristol NHS Trust, Beckspool Road, Frenchay, Bristol, BS16 1LE, United Kingdom.

Spine Deformity
|December 9, 2016
PubMed
Summary

Mobile degenerative spondylolisthesis (DS) at L4-L5 is not linked to pelvic parameters. Instead, it is associated with specific facet joint and disc degeneration characteristics, indicating a need for further research into these factors.

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Area of Science:

  • Orthopedics
  • Radiology
  • Spine Surgery

Background:

  • Degenerative scoliosis is common in older adults.
  • Sacropelvic morphology influences lumbar spine mechanics.
  • No in vivo data link pelvic parameters to mobile spondylolisthesis.

Purpose of the Study:

  • Identify factors determining mobile degenerative spondylolisthesis (DS) at L4-L5.
  • Investigate the association between pelvic parameters and mobile DS.
  • Analyze facet joint and disc degeneration in mobile vs. non-mobile DS.

Main Methods:

  • Sixty patients with L4-L5 DS were analyzed.
  • Patients were grouped into mobile (A) or non-mobile (B) based on imaging comparisons.
  • Assessed slip grade, lordosis, pelvic parameters, facet characteristics, and disc degeneration (Pfirrmann grade).
Keywords:
Degenerative spondylolisthesisPelvic parametersRisk factors

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Main Results:

  • No significant differences in pelvic parameters or lumbar lordosis between mobile and non-mobile DS groups.
  • Facet angle approached significance (p=0.058) between groups.
  • Significant differences found in facet cartilage/sclerosis (p=0.01) and disc degeneration (p<0.0001).

Conclusions:

  • Sagittal pelvic parameters do not differentiate mobile from non-mobile DS at L4-L5.
  • Mobile DS is associated with more sagittally oriented facets.
  • Higher disc degeneration (Pfirrmann grade) and facet degeneration scores are linked to mobile DS.