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Eur Spine J. 2017 Dec;26(12):3096-3105. doi: 10.1007/s00586-017-5275-4. Epub 2017 Aug 23.

A new classification system for degenerative spondylolisthesis of the lumbar spine.

Author information

1
Department of Spinal Surgery Unit 1, C.H.U Tripode Pellegrin, Bordeaux University Hospital, Université de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France.
2
School of Physics and Astronomy, University of Exeter, Exeter, UK.
3
Department of Spinal Surgery Unit 1, C.H.U Tripode Pellegrin, Bordeaux University Hospital, Université de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France. soufiane.ghailane@gmail.com.

Abstract

PURPOSE:

There is no consensus for a comprehensive analysis of degenerative spondylolisthesis of the lumbar spine (DSLS). A new classification system for DSLS based on sagittal alignment was proposed. Its clinical relevance was explored.

METHODS:

Health-related quality-of-life scales (HRQOLs) and clinical parameters were collected: SF-12, ODI, and low back and leg pain visual analog scales (BP-VAS, LP-VAS). Radiographic analysis included Meyerding grading and sagittal parameters: segmental lordosis (SL), L1-S1 lumbar lordosis (LL), T1-T12 thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis (SVA). Patients were classified according to three main types-1A: preserved LL and SL; 1B: preserved LL and reduced SL (≤5°); 2A: PI-LL ≥10° without pelvic compensation (PT < 25°); 2B: PI-LL ≥10° with pelvic compensation (PT ≥ 25°); type 3: global sagittal malalignment (SVA ≥40 mm).

RESULTS:

166 patients (119 F: 47 M) suffering from DSLS were included. Mean age was 67.1 ± 11 years. DSLS demographics were, respectively: type 1A: 73 patients, type 1B: 3, type 2A: 8, type 2B: 22, and type 3: 60. Meyerding grading was: grade 1 (n = 124); grade 2 (n = 24). Affected levels were: L4-L5 (n = 121), L3-L4 (n = 34), L2-L3 (n = 6), and L5-S1 (n = 5). Mean sagittal parameter values were: PI: 59.3° ± 11.9°; PT: 24.3° ± 7.6°; SVA: 29.1 ± 42.2 mm; SL: 18.2° ± 8.1°. DSLS types were correlated with age, ODI and SF-12 PCS (ρ = 0.34, p < 0.05; ρ = 0.33, p < 0.05; ρ = -0.20, and p = 0.01, respectively).

CONCLUSION:

This classification was consistent with age and HRQOLs and could be a preoperative assessment tool. Its therapeutic impact has yet to be validated.

LEVEL OF EVIDENCE:

4.

KEYWORDS:

Classification system; Clinical relevance; Degenerative spondylolisthesis; Lumbar spine; Spondylolisthesis

PMID:
28836019
DOI:
10.1007/s00586-017-5275-4
[Indexed for MEDLINE]

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