Analysis Of Oblique And Sagittal Parameters In Lumbar 5 Spondylolysis Based On X-ray In Adults

ObjectiveTo investigate the difference and correlation of oblique and sagittal parameters in L5 spondylolysis and L5 isthmic spondylolisthes is based on X-ray and its clinical significance.MethodsFrom 1998 August to 2015 May, fifty-five patients(25 males,30 females) with L5 spondylolysis or L5 isthmic spondylolisthesis were treated. The mean age was 43.82±11.01 years old. All patients were diagnosed exactly through history collection,. physical examination and imaging examination. The imaging examination includes a-p 、 sagittal and 45°oblique X-ray plain film, computed tomography(CT),magnetic resonance imaging(MRI). Scoliosis, tumor, infection, spina bifida occulta, fracture,spine malformation, metabolic bone disease and the patients who had previous surgery were all excluded. All patients were divided into 2 groups (A and B). The patients in group A were suffered from L5 spondylolysis without spondylolisthesis and patients in group B were suffered from L5 isthmic spondylolisthesis. The software of Digimizer was used to measure the parameters on oblique X-ray:the distance from the L4 inferior articular process to the L5 isthmus(d), the distance from the sacral 1 (S1)superior articular process to the L5 isthmus(s), the width of L5 isthmus(w), the height of L4 vertebral body(h1); the parameters on sagittal X-ray:the height of L5/S1 intervetebral space(k), the height of L4 vertebral body(h2), lumbar lordosis angle(LLA), sacral slope angle(SSA), lumbar gravity line index, spondylolisthesis rate. In order to make the different measured data have comparability, it is needed to take the count of d÷h1、s÷h4、w÷h1、k÷h2. Independent-samples t test was used to check the difference of d/h1、s/h1、w/h1、 k/h2、LLA、SSA、lumbar gravity line index and age between group A and B. Pearson correlation analysis was used to check the correlation between different parameters.Resultsd/h1、s/h1、k/h2 were greater in group A than those in group B (P<0.05). Lumbar gravity line index was smaller than that in group B (P<0.05). d/h1 had linear positive correlation with s/h1, linear negative correlation with LLA and spondylolisthesis rate (P<0.05). k/h2 had linear negative correlation with lumbar gravity line index, spondylolisthesis rate and age(P<0.05). Lumbar gravity line index had linear positive correlation with LLA、SSA and spondylolisthesis rate (P<0.05) Spondylolisthesis rate had linear positive correlation with age> lumbar gravity line index, linear negative correlation with k/h2% d/h1 and s/h1 (P<0.05)ConclusionsThe investigation of lumbar oblique and sagittal parameters is of great significance to the development of lumbar spondylolysis. Stress from superior and inferior articular process of adjacent segments, degeneration of intervertebral disc, increasement of lumbar gravity line index may be the reasons for lumbar spondylolysis developing to isthmic spondylolisthesis.