Correlation Between The4th Lumbar Degenerative Spondylolisthesis And Radiographic Parameters

Objective: To investigate the relationship between radiographicparameters and the4th lumbar degenerative spondylolisthesis.Methods: From April2010to April2012,60patients with the4thlumbar degenerative spondylolisthesis (DLS) were enrolled in DLS group,56healthy volunteers were recruited in control group. A series of radiographicparameters were measured in the two groups, including disc height（DH）,discdegeneration index（DDI）,L4vertebral inclination angle(L4-VA),pelvicincidence (PI), L4vertebral size (L4-VS), lumbar lordosis angle (LLA), facetjoint angulation (FJA) of cephalad and caudad portions,bone mineraldensity(BMD). Student’s test was used to compare difference of parametersbetween two groups. Multivariate logistic regression analysis was used toreveal risk factors of the development of DLS.Results: Fifty-three cases of L4spondylolisthesis in DLS group wereclassified into grade Ⅰ,7cases of L4spondylolisthesis were classified intograde Ⅱ. The average Boxall index were (0.1724±0.0465). There wassignificant difference of DH, DDI, L4-VS, L4-VA, LLA, PI, FJA, BMDbetween DLS group and control group (t=2.28-9.33，P=0.021-0.043). Therewas significant difference of delta FJA of cephlad and caudad portions inL3-4,L4-5between DLS group and control group (t=3.398-28.122，P=0.000-0.039). There was no significant difference of asymmetry variationof FJA in L3-4,L4-5between DLS group and control group (t=0.209-0.465，P=0.295-0.858). Multivariate logistic regression analysis showed that L4-DSwas more frequent among patients with smaller L4-VS(OR=1.01，95%CI=1.000～1.024，P=0.048), larger L4-VA (OR=1.88，95%CI=14.000～14.600，P=0.037), larger LLA (OR=1.90，95%CI=1.600～15.800，P=0.040),larger PI (OR=2.58，95%CI=14.000～19.600，P=0.029)and the more sagittal FJA（OR=2.46,95%CI=1.400～16.400，P=0.035）than those in control group.Conclusions: DLS is signifantly correlated with L4-VS, L4-VA, LLA,PI, FJA. They may be risk factors of the development of DLS.