EFFECTS OF SAGITTAL BALANCE DIFFERENCES ON SPONDYLOLISTHESIS

ABSTRACT Objectives: This study aimed to compare the lumbar lordosis (LL) and spinopelvic parameters of patients with stage 1–2 spondylolisthesis to those of the normal population and demonstrate the importance of these parameters in sagittal balance. Methods: The lumbosacral parameters on the lateral radiographs of a total of 125 patients were retrospectively compared. Lumbosacral parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis angle (LLA), L5 incidence (L5I), L5 slope (L5S), and sacral table angle (STA) were compared between groups. Results: Comparison of the parameters between groups revealed no sex-based differences (p > 0.05). Conclusions: Abnormal sagittal spinopelvic parameters are commonly examined for their effects on the development of spondylolisthesis and should be used in routine practice. We found that the low SS values in our study, unlike those of other similar studies, may be a compensatory mechanism developed to reduce pain and maintain sagittal balance. Level of Evidence II; retrospective study.摘要 研究目的：本研究旨在对比1~2期腰椎滑脱症患者与正常人群的腰椎前凸（lumbar lordosis, LL）及脊柱骨盆参数，阐明此类参数在矢状位平衡中的重要性。方法：本研究对共计125例患者的腰骶部侧位X线片参数进行回顾性对比分析，比较两组间的腰骶部参数，包括骨盆入射角（pelvic incidence, PI）、骨盆倾斜角（pelvic tilt, PT）、骶骨倾斜角（sacral slope, SS）、腰椎前凸角（lumbar lordosis angle, LLA）、L5入射角（L5 incidence, L5I）、L5倾斜角（L5 slope, L5S）以及骶骨终板角（sacral table angle, STA）。结果：组间参数对比显示，性别差异无统计学意义（p > 0.05）。结论：异常矢状位脊柱骨盆参数常被用于评估其对腰椎滑脱症发生发展的影响，且应纳入临床常规诊疗实践。本研究发现，与其他同类研究不同，本研究中较低的骶骨倾斜角（SS）或为患者为减轻疼痛、维持矢状位平衡而形成的代偿机制。证据等级：II级；回顾性研究。