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Rev Esp Cir Ortop Traumatol. 2017 Sep - Oct;61(5):343-348. doi: 10.1016/j.recot.2017.05.002. Epub 2017 Jul 26.

Proximal sacral deformity: a common element in lytic isthmic spondylolisthesis at L5 and in degenerative spondylolisthesis at L4-L5 segment. Two apparently very different etiopathogenic entities.

[Article in English, Spanish]

Author information

1
Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
2
Hospital Universitario Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
3
Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España. Electronic address: madxxuno@hotmail.com.

Abstract

A radiographic study was carried out to investigate the relationship between proximal sacral sagittal anatomy (either kyphosis or lordosis) and either isthmic or degenerative spondylolisthesis. In addition, we studied whether there is a relationship between proximal sacral kyphosis and the degree of such listhesis in the case of L5 isthmic spondylolisthesis. Lateral standing x-rays were used from 173 patients, ninety of whom had degenerative spondylolisthesis L4-L5, and eighty-three an isthmic spondylolisthesis of L5 (67 low-grade and 16 high-grade) and compared with a control group of 100 patients adjusted by age and gender, without any type of spondylolisthesis. Listhesis was graded using Meyerding's classification and the proximal sacral kyphosis angle (CSP) was measured between S1 and S2 posterior walls, according to Harrison's method. In our series, there was a proximal sacral kyphosis in both types of spondylolisthesis, greater in the lytic type. By contrast, the control group had a proximal sacral lordosis. The differences were statistically significant. Therefore, we concluded that there was a proximal sacral kyphosis in patients with both degenerative and isthmic lytic spondylolisthesis, but with our results, we were not able to ascertain whether it is a cause or a consequence of this listhesis.

KEYWORDS:

Alineamiento sagital; Anatomy; Anatomía; Columna vertebral; Espondilolistesis; Isthmus; Istmo; Lumbar; Sacro; Sacrum; Sagittal alignment; Spine; Spondylolisthesis

PMID:
28755923
DOI:
10.1016/j.recot.2017.05.002
[Indexed for MEDLINE]

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