Radiographic parameter differences in degenerative scoliosis with/without degenerative lumbar spondylolisthesis

Area of Science:

• Spine surgery
• Orthopedics
• Radiology

Background:

• Degenerative scoliosis (DS) and degenerative lumbar spondylolisthesis (DLS) are common spinal conditions.
• Understanding the imaging differences between DS with and without DLS is crucial for surgical planning.

Purpose of the Study:

• To investigate and compare the imaging characteristics of degenerative scoliosis (DS) in patients with and without degenerative lumbar spondylolisthesis (DLS).

Main Methods:

• 124 patients undergoing DS correction were divided into two groups: DS with DLS (n=58) and DS without DLS (n=66).
• Preoperative, postoperative, and 2-year follow-up coronal and sagittal imaging parameters were analyzed.
• Patients were classified using SRS-Schwab and modified Abelin-Genevois classifications, with clinical outcomes assessed by JOA, VAS, and ODI scores.

Main Results:

• DS with DLS predominantly affected the L3/4 segment, while DS without DLS involved L2/3 or L3/4.
• Group A (DS with DLS) showed higher classifications in Schwab (type III) and Abelin-Genevois (AG4) compared to Group B (DS without DLS) (type II and AG3, respectively).
• Preoperative CVA, Cobb angle, and SVA were significantly larger, while LL and DH were smaller in DS with DLS compared to DS alone, particularly with higher DS severity.

Conclusions:

• DS with DLS is characterized by greater preoperative coronal and sagittal imbalance, larger CVA, SVA, and Cobb angles, and smaller LL compared to DS without DLS.
• The imaging differences are more pronounced in cases of severe degenerative scoliosis.