Abstract
BackgroundThe impact of sagittal spinopelvic alignment on spondylolysis is well established in Caucasian populations. However, prior studies suggest that people from different ethnological backgrounds showed divergence, and a few studies that focused on Asian populations reported conflicting results. The aim of this study is to use the EOS imaging system to evaluate the spinopelvic parameters of spondylolysis patients, and their relationship with spondylolisthesis, disc degeneration, and age in a Taiwanese population.MethodsRadiographic sagittal spinopelvic parameters for 45 spondylolysis patients and 32 healthy people were evaluated, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), thoracic kyphosis (TK), and lumbar lordosis (LL). The spinopelvic parameters were compared between spondylolytic and control groups. These parameters were further compared between spondylolytic subjects with and without spondylolisthesis, with and without high-grade disc degeneration, and young (< 30 years old) and middle-aged.ResultsThe PI and LL of the spondylolytic group (52.6°±12.0° and 41.3°±15.2°) were significantly higher than those of the healthy control group (47.16°±7.95° and 28.22°±10.65°). Further analysis of the spondylolytic patients revealed that those with high-grade disc degeneration were more prone to spondylolisthesis (92.3 %) compared to those without (50 %; p = 0.001). The middle-aged group had significantly higher rates of spondylolisthesis (80 %) and high-grade disc degeneration (52.4 %) compared with those for the young group (45 and 16.7 %, respectively; p = 0.017 and 0.047, respectively). No statistically significant difference in the sagittal spinopelvic parameters was found when spondylolytic patients were divided according to the occurrence of spondylolisthesis or high-grade disc degeneration.ConclusionsIn a Taiwanese population, PI and LL were significantly larger in spondylolytic patients. Disc degeneration and age were associated with the occurrence of spondylolisthesis. Ethnological differences should thus be taken into account when making clinical decisions regarding spondylolysis in a Taiwanese population.
Highlights
Spondylolysis refers to a defect of the vertebral pars interarticularis
In a Taiwanese population, pelvic incidence (PI) and lumbar lordosis (LL) were significantly larger in spondylolytic patients
Ethnological differences should be taken into account when making clinical decisions regarding spondylolysis in a Taiwanese population
Summary
Spondylolysis refers to a defect of the vertebral pars interarticularis. It can result in vertebral slippage relative to the adjacent vertebrae, a condition called spondylolisthesis. An increase in pelvic incidence (PI) is correlated with lumbar lordosis in spondylolysis patients compared with healthy people [1,2,3,4,5] the increase in PI is correlated with an increasing slip grade in spondylolisthesis patients [4, 6,7,8,9]. Another common pathological change in spondylolysis patient is intervertebral disc (IVD) degeneration below the lytic level [10]. The aim of this study is to use the EOS imaging system to evaluate the spinopelvic parameters of spondylolysis patients, and their relationship with spondylolisthesis, disc degeneration, and age in a Taiwanese population
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