Year-end Sale % OFF 
Abstract
BackgroundA classification of lumbosacral spondylolisthesis has been proposed recently. This classification describes eight distinct types of spondylolisthesis based on the slip grade, the degree of dysplasia, and the sagittal sacro-pelvic balance. The objectives of this study are to assess the reliability of this classification and to propose a new and refined classification.MethodsStanding posteroanterior and lateral radiographs of the spine and pelvis of 40 subjects (22 low-grade, 18 high-grade) with lumbosacral spondylolisthesis were reviewed twice by six spine surgeons. Each radiograph was classified based on the slip grade, the degree of dysplasia, and the sagittal sacro-pelvic balance. No measurements from the radiographs were allowed. Intra- and inter-observer reliability was assessed using kappa coefficients. A refined classification is proposed based on the reliability study.ResultsAll eight types of spondylolisthesis described in the original classification were identified. Overall intra- and inter-observer agreement was respectively 76.7% (kappa: 0.72) and 57.0% (kappa: 0.49). The specific intra-observer agreement was 97.1% (kappa: 0.94), 85.0% (kappa: 0.69) and 88.8% (kappa: 0.85) with respect to the slip grade, the degree of dysplasia, and the sacro-pelvic balance, respectively. The specific inter-observer agreement was 95.2% (kappa: 0.90), 72.2% (kappa: 0.43) and 77.2% (kappa: 0.69) with respect to the slip grade, the degree of dysplasia, and the sacro-pelvic balance, respectively.ConclusionThis study confirmed that surgeons can classify radiographic findings into all eight types of spondylolisthesis. The intra-observer reliability was substantial, while the inter-observer reliability was moderate mainly due to the difficulty in distinguishing between low- and high-dysplasia. A refined classification excluding the assessment of dysplasia, while incorporating the assessment of the slip grade, sacro-pelvic balance and global spino-pelvic balance is proposed, and now includes five types of lumbosacral spondylolisthesis.
Highlights
A classification of lumbosacral spondylolisthesis has been proposed recently
Two observers did not identify any radiograph with a type 3 spondylolisthesis (Table 1)
This study evaluated the reliability of a classification previously proposed for lumbosacral spondylolisthesis
Summary
A classification of lumbosacral spondylolisthesis has been proposed recently This classification describes eight distinct types of spondylolisthesis based on the slip grade, the degree of dysplasia, and the sagittal sacro-pelvic balance. Surgical guidelines and outcome studies for spondylolisthesis are primarily based on slip grade [3,4,5,6] These classifications [1,2] do no take sagittal sacro-pelvic balance into account, many more recent studies have suggested its importance in the evaluation, progression and treatment of spondylolisthesis [7,8,9,10,11,12,13,14,15,16,17,18,19,20]. These findings may in part explain the wide variability reported in the literature concerning surgical techniques and outcomes for spondylolisthesis, and support our opinion that an optimal algorithm for treatment has yet to be defined
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
