A new classification system for degenerative spondylolisthesis of the lumbar spine

摘要

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? 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 ? ρ ?=?0.33, p ? 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.