Large Lumbar Lordosis and Coronal Deformity Angular Ratio Are Risk Factors for Adolescent Idiopathic Scoliosis in Patients With Lumbar Spondylolysis

Abstract

The features of lumbar curves in patients with lumbar spondylolisthesis (LS) are unclear. The aim of this retrospective study was to present the clinical and radiologic characteristics of scoliosis due to LS and LS concurrent with main thoracolumbar/lumbar adolescent idiopathic scoliosis (AIS). This study was conducted as a single-center retrospective comparative study on 56 pediatric spondylolisthesis patients with main thoracolumbar/lumbar curves. Cases were divided into 2 groups according to the course of scoliosis after spinal surgery of LS. Sagittal spinopelvic parameters and scoliotic characteristics were compared between the 2 groups. The prevalence of scoliosis was 15.3% in pediatric LS patients in our study population. Lumbar lordosis (LL), Cobb angle, apical rotation, and coronal deformity angular ratio (C-DAR) were higher in the LS concurrent with AIS group than in the LS with functional scoliosis group (P < 0.05), while curve span, apical vertebral translation, and central sacral vertical line to C7 plumb line were lower (P < 0.05). Logistic regression analyses and receiver operating characteristic curves showed that LL and C-DAR were significant risk factors of unresolved lumbar curves after spinal surgery for LS, with a cutoff value of 51.5°and 3.5, respectively. Lumbar scoliosis may develop due to LS, or a concurrent condition to LS. LL and C-DAR are the features that differentiate AIS from functional scoliosis in patients with LS.