The Differences Of Sagittal Spinopelvic Parameters Between Lumbar Degenerative Spondylolisthesis And Degenerative Spinal Stenosis

Objectives 1.The purpose of this study was to compare the differences of sagittal spinopelvic parameters among lumbar degenerative spondylolisthesis(DSPL),degenerative spinal stenosis(DSS)and normal Chinese population.2.To explore the risk factors related to the development and progression of lumbar degenerative spondylolisthesis.Methods 1.A total of seventy-one patients who was diagnosed lumbar degenerative spondylolisthesis and degenerative spinal stenosis respectively from the February 2016 to February 2017 were assessed in this study.There were 36 cases diagnosed lumbar degenerative spondylolisthesis,including 2 males and 34 females between 46 and 83 years of age.35 cases with degenerative spinal stenosis were enrolled,including 22 males and 12 females between 40 and 81 years of age.All those patients have the complete information of the whole spine lateral radiographs.All the following parameters were measured on the whole spine lateral radiographs by two spinal surgeon using PACS(Picture Archiving and Communication Systems): pelvic incidence(PI),pelvic tilt(PT),sacral slope(SS),lumbar lordosis(LL),thoracic kyphosis(TK),pelvic angle(PA),lumbopelvic lordosis(PR-LI—PR-L5),total lumbopelvic lordosis(PR-T12),pelvic morphology(PR-S1),sagittal vertical axis from the C7 plumb line(SVA),L4 slope and L5 slope.2.All the parameters from lumbar degenerative spondylolisthesis and degenerative spinal stenosis were compared with the normal parameters of Chinese population.Student’s t-test was used to compare each parameter between the DSPL and DSS group.Correlations among the spinopelvic parameters of the two group were determined using Pearson correlation coefficient.A p value less than 0.05 was considered to be statistically significant.Results 1.Several spinopelvic parameters,PI,SS,and LL in the lumbar degenerative spondylolisthesis group were significantly greater than those in the degenerative spinal stenosis group and normal parameters of Chinese population(p<0.01).2.The PT,PA and SVA of the DSPL group and DSS group were both significantly greater than those of the normal parameters(p<0.01).There were no difference in PR-T12 between DSPL group and normal parameters(p>0.05).The PR-T12 of the DSS group was less than that of the normal parameters(p<0.01).3.The PR-L4,PR-L5,PR-S1 of the DSS group were significantly greater than those of DSPL group(p<0.01).4.In the DSPL group,PR-T12 was more strongly correlated with PA(r=-0.829,p<0.001)than with LL(r=0.664,p<0.001)and TK(r=0.582,p<0.001).In the DSS group,PR-T12 was more strongly correlated with LL(r=0.854,p<0.001)and TK(r=0.616,p<0.001)than with PA(r=-0.582,p<0.001).Conclusions 1.There were different changing of spinopelvic aligments between lumbar degenerative spondylolisthesis and degenerative spinal stenosis when the spine and pelvic constantly changing to maintain the whole spine sagittal balance.2.Greater PI may lead to the development and progression of lumbar degenerative spondylolisthesis.The lower lumbopelvic lordosis in the DSS was significantly greater than that in the DSPL(PR take negative values).3.Different compensatory mechanisms may contribute to the maintenance of spinopelvic sagittal alignment in lumbar degenerative spondylolisthesis and degenerative spinal stenosis patients.