Correlation Between Clinical Efficacy Of Chiropractic Therapy And Spinopelvic Parameters In The Treatment Of Degenerative Lumbar Spondylolisthesis

Objective: To explore the correlation between the changes of spinopelvic parameters and clinical efficacy in the treatment of degenerative lumbar spondylolisthesis.Methods: A retrospective study was conducted on the inpatients with degenerative lumbar spondylolisthesis who were treated in the pain Department of the second affiliated Hospital of Henan University of traditional Chinese Medicine from September 2018 to September 2020.Patients with single-segment degenerative spondylolisthesis were enrolled.All patients took anteroposterior and lateral lumbar Xray films before and after treatment.Four spinal and pelvic parameters,including pelvic incidence angle(PI),pelvic inclination angle(PT),sacral tilt angle(SS)and lumbar kyphosis angle(LL),were measured by PACS imaging system.The clinical efficacy was evaluated by pain VAS score and RMDQ score.Before and after treatment,VAS score,RMDQ score,LL,PT,PI and SS were compared by paired sample Wilcoxon rank sum test.Finally,Spearman correlation analysis was used to analyze the relationship between spinal and pelvic parameters and clinical efficacy.Results: A total of 65 patients with single segmental degenerative spondylolisthesis were included,including 21 males(32%)and 44 females(68%),with an average age of 60.94 ± 5.47 years.56 cases(86%)of grade Ⅰ degree spondylolisthesis and 9 cases(14%)of degree Ⅱdegree spondylolisthesis.There were4 cases of L2 spondylolisthesis(6%),11 cases of L3 Spondylolisthesis(17%),37 cases of L4 Spondylolisthesis(57%),13 cases of L5/S1 spondylolisthesis(20%).42 patients were complicated with lumbar spinal stenosis(65%).After treatment,the pain VAS score and RMDQ score of all patients decreased,and the symptoms of pain and dysfunction were improved to some extent.Through the comparison of spinal and pelvic parameters before and after treatment,it was found that LL,PI and SS decreased,while PT angle increased,the difference was statistically significant.In the correlation analysis,LL before treatment was negatively correlated with pain VAS score after treatment(rs=-0.319,P < 0.05),Pi value before treatment was positively correlated with pain VAS score and RMDQ score before and after treatment,PT value before treatment was positively correlated with pain VAS score and RMDQ score,and SS value before treatment was positively correlated with pain VAS score and RMDQ score after treatment.There was also a certain correlation between spinal and pelvic parameters and pain VAS score and RMDQ score after treatment,but there was no correlation between the changes of spinal and pelvic parameters and pain VAS score and RMDQ score improvement before and after treatment.Conclusion: For patients with degenerative lumbar spondylolisthesis,the angle of spinal and pelvic parameters can be adjusted to some extent,but there is no correlation between the changes of spinal and pelvic parameters before and after treatment and the clinical effect.