Relationship between variations of severe isthmic spondylolisthesis spino-pelvic parameters and clinical symptoms

Abstract

To explore the relationship between variations of severe isthmic spondylolisthesis spino-pelvic parameters and clinical symptoms. A retrospective study of spino-pelvic parameters was conducted for 45 patients with L5 severe isthmic spondylolisthesis. Their spino-pelvic parameters were analyzed on preoperative full spinal radiography: grade of spondylolisthesis, pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), SFHD, SFVD, SC7D and T9 tilting angle. According to the Oswestry score, the patients with low back pain were divided into light and severe groups. T-tests were used to compare their parameters. The analyses of multiple factor correlation, linear regression and stepwise regression were used to examine the associations between all parameters and Oswestry score. Grade of spondylolisthesis, PT, LL, T9 tilting angle, SFHD, SC7D, PT/SS, SFHD/SFVD, LL/TK were significantly greater and SS, SFVD were significantly smaller for patients with severe low back pain versus light low back pain (P < 0.05). PI or TK had no statistically significant difference between two groups. Multiple factor correlation, linear regression and stepwise regression: Grade of spondylolisthesis, PT, SC7D, LL and SFHD had significant positive correlations with Oswestry score. Degree of positive correlation: Grade of spondylolisthesis > SC7D > PT > LL > SFHD. And PI, TK or T9 tilting angle had no significant correlation with Oswestry score. SS and SFVD had significant negative correlations with Oswestry score. Degree of negative correlation: SS > SFVD. PT/SS, SFHD/SFVD and LL/TK had significant positive correlation with Oswestry score. Degree of positive correlation: PT/SS> SFHD/SFVD > LL/TK. Clinical symptoms of severe isthmic spondylolisthesis have significant positive correlations with grade of spondylolisthesis, PT, SC7D, LL, SFHD, PT/SS, SFHD/SFVD, LL/TK and significant negative correlations with SS and SFVD. Low back pain symptom has no significant correlation with PI, TK or T9 tilting angle.