Degenerative Spondylolisthesis in the Fifth Lumbar Vertebra and Radiographic Parameters: A Correlation Analysis.
METHODS
A retrospective study.


OBJECTIVE
This study aimed to analyze the relationships between degenerative spondylolisthesis in the fifth lumbar vertebra (L5-DS) and radiographic parameters and to further determine the radiographic predictors of the development of L5-DS.


BACKGROUND
Degenerative lumbar spondylolisthesis (DLS) is a common degenerative disease of the spine; however, the correlations between L5-DS and radiographic parameters remain controversial.


METHODS
This retrospective case-control study was conducted in our hospital. Between 2011 and 2014, a total of 84 subjects with L5-DS were enrolled in the DLS group, and 56 healthy volunteers were recruited to the control group. A series of radiographic parameters, including the bone mineral density, disk degenerative index, disk height, L5 vertebral size (L5-VS), lumbar lordosis angle (LL), sacral slope angle (SS), pelvic incidence (PI), facet joint angulations (FJA) of the cephalad and caudad portions, and asymmetry of the FJA, were measured in both groups by 3 examiners.


RESULTS
The bone mineral density, disk degenerative index, disk height, L5-VS, LL, SS, PI, and FJA exhibited significant differences (P=0.014-0.045) between the DLS and control groups. Significant changes in the FJA of the cephalad and caudad portions in the L4-L5 and L5-S1 segments were observed between the 2 groups (P=0.00, 0.00), whereas no significant differences in the asymmetries of FJA were observed in the L4-L5 or L5-S1 segments (P=0.605-0.972). Among all of the parameters, the L5-VS (P=0.025), SS (P=0.020), LL (P=0.031), PI (P=0.014), and FJA (P=0.022) were identified as being associated with the DLS group by multiple logistic regression analysis.


CONCLUSIONS
In this study, SS, LL, PI, and a more sagittal FJA were proven to be risk factors for L5-DS, whereas L5-VS was found to be a likely protective factor against L5-DS. These parameters should be considered predictors of L5-DS.
Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Qian
Q
Chen
Lu
L
Cao
Chong
C
Bian
Hui-Ren
HR
Wang
Hong
H
Lin
Xi-Lei
XL
Li
Yun-Qi
YQ
Jiang
Jian
J
Dong
D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013168:Spondylolisthesis / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging