Analysis of Spinopelvic Parameters with L5 as the New Sacrum after Fusion in High-Grade Spondylolisthesis: A Possible Explanation for Satisfactory Results with In-Situ Fusion

Retrospective case series. To correlate functional outcomes with spinopelvic parameters in patients with high-grade spondylolisthesis (HGS) treated with instrumented surgery or reduction and fusion. Satisfactory functional outcomes are reported with reduction and fusion strategies in HGS. However, r...

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Bibliographic Details
Published in:Asian spine journal 2018, 12(1), , pp.103-111
Main Authors: Rajasekaran, Shanmuganathan, Das, Gurudip, Aiyer, Siddharth Narasimhan, Kanna, Rishi Mugesh, Shetty, Ajoy Prasad
Format: Article
Language:English
Subjects:
Clinical Study
Kyphosis
Patients
Pelvis
Sacrum
Spondylolisthesis
Statistical analysis
Surgery
정형외과학
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Summary:Retrospective case series. To correlate functional outcomes with spinopelvic parameters in patients with high-grade spondylolisthesis (HGS) treated with instrumented surgery or reduction and fusion. Satisfactory functional outcomes are reported with reduction and fusion strategies in HGS. However, reasons for this are unclear. We hypothesize that following lumbosacral fusion, the L5 becomes part of the sacrum, which improves spinopelvic parameters, resulting in equivalent functional outcomes in both surgical methods. Twenty-six patients undergoing HGS (reduction group A, 13; group B, 13) were clinically evaluated using the Oswestry Disability Index (ODI), short form-12 (SF-12), and Visual Analogue Scale (VAS) scores. Spinopelvic parameters, including pelvic incidence, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), lumbosacral kyphosis (LSK) angle, and sacrofemoral distance (SFD) were measured preoperatively from S1 and postoperatively from L5 as the new sacrum at 1 year follow-up. Sagittal alignment was assessed using the sagittal vertical axis. Both groups were comparable in terms of age, sex, severity of slip, and preoperative spinopelvic parameters ( >0.05). Postoperative VAS, SF-12, and ODI scores significantly improved in both groups (
ISSN:1976-1902
1976-7846
DOI:10.4184/asj.2018.12.1.103