Imaging characteristics and correlation analysis of lumbar spondylolisthesis with Baastrup's disease

To observe and analyze the imaging characteristics of lumbar spondylolisthesis with Baastrup's disease and to explore the correlation between types of spondylolisthesis and Baastrup's disease.

This retrospective cohort study analyzed 170 patients with lumbar spondylolisthesis and Baastrup's disease treated in our hospital from January 2020 to December 2023, including 98 males and 72 females, aged 40-73 years.Patients were divided into degenerative spondylolisthesis with Baastrup's disease (Group A, 81 cases) and isthmic spondylolisthesis with Baastrup's disease (Group B, 89 cases).Imaging parameters related to Baastrup's disease were evaluated in both groups, including the location and number of segments affected by Baastrup's disease, degeneration of the interspinous ligament (Keorochana classification), degeneration of spinous process bone, inferior-superior interspinous distance(ISID), superior interspinous distance(SID), segmental spinous process deviation, segmental spinous process rotation, the presence of spinous process dysplasia and lumbosacral transitional vertebrae(LSTV).Group differences in these parameters were compared, and Spearman correlation analysis was used to assess the correlation between spondylolisthesis types and Baastrup's disease imaging parameters.

Except for the spondylolisthesis segments, there were no statistically significant differences in baseline characteristics between the two groups (P > 0.05).Regarding imaging parameters of Baastrup's disease,no statistically significant differences were found between groups in terms of interspinous ligament degeneration, superior interspinous distance(SID), segmental spinous process deviation, segmental spinous process rotation, spinous process dysplasia, and lumbosacral transitional vertebrae(LSTV) among patients with single-segment Baastrup's disease (P > 0.05).However, significant differences were observed in the location of Baastrup's disease, spinous process bone degeneration, and inferior-superior interspinous distance(ISID) (P < 0.05).In patients with multisegmental Baastrup's disease, all parameters showed no statistically significant differences except for the inferior-superior interspinous distance(ISID), which exhibited a significant difference (P > 0.05).Spearman correlation analysis showed that:in cases of lumbar spondylolisthesis with single-segment Baastrup's disease, the type of spondylolisthesis was strongly positively correlated with the location of Baastrup's disease (r = 0.859, P < 0.001), a moderate positive correlation with inferior-superior interspinous distance(ISID) (r = 0.463, P < 0.001), and a moderate negative correlation with spinous process bone degeneration (r = -0.442, P < 0.001).In lumbar spondylolisthesis with multisegmental Baastrup's disease, the type of spondylolisthesis showed a moderate positively correlation with the inferior-superior interspinous distance(ISID) (r = 0.482, P < 0.001).

Degenerative spondylolisthesis with single-segment Baastrup's disease commonly occurs at the same level.In contrast, isthmic spondylolisthesis is more commonly associated with Baastrup's disease at the segment above the slipped level, accompanied by more severe spinous process bone degeneration and a smaller inferior-superior interspinous distance(ISID).In lumbar spondylolisthesis patients with multisegmental Baastrup's disease, the inferior-superior interspinous distance(ISID) is often smaller in isthmic spondylolisthesis compared to degenerative spondylolisthesis.