Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

EndNote Style
Original Article
Correlation between spinopelvic angles and radiological findings of lumbar spondylolisthesis patients
Aims: Spondylolisthesis is a deformity in which the upper segment is displaced anteriorly or posteriorly in the spine relative to the lower segment. In this pathology, which often causes instability, surgical treatment may be required. Also, patient’s radiological images should be evaluated carefully before treatment. We aimed to analyze clinical and radiological data with spinopelvic angles of the lumbar spondylolisthesis patients in our research.
Methods: 6593 patients who applied to the neurosurgery outpatient clinic with complaints of low back pain between January 2019 - December 2022 were retrospectively analyzed. The radiological findings of patients with spondylolisthesis, whose lumbar MRI and lumbar CT were obtained appropriately along with X-ray were evaluated in detail. Age, gender, listhesis level and degree, Cobb angle, pelvic incidence, pelvic tilt, sacral slope angle, Modic degeneration, vacuum phenomenon, annulus rupture, Schmorl nodule, facet hypertrophy, osteophyte, maximum AP central canal diameter and joint lysis has been examined in these patient tests. The relationships of these data with each other were evaluated statistically.
Results: 58 female and 5 male patients were found to be eligible for the study. Mean age was 59 (min 22, max 81). Grade 1 listhesis was detected in 52 of the patients. Listhesis was observed at the level of L5-S1 in 31 patients, L4-L5 in 24 patients and L3-L4 in 8 patients. A direct correlation was found between age and vacuum phenomenon, osteophyte, presence of L5-S1 listesis and lysis. Similar correlation was found between pelvic incidence and sacral slop angle, facet hypertrophy and Modic type 2 degeneration. Also, there was a direct correlation between pelvic incidence and pelvic tilt; between facet hypertrophy and vacuum phenomenon and lysis; ligamentum hypertrophy and vacuum phenomenon; and facet hypertrophy and lower level listesis (p 0.05).
Conclusion: Spondylolisthesis is an important problem that requires treatment in spine surgery. Radiologically determined parameters can give important knowledge about the severity of this pathology. These findings should be taken into consideration in the treatment of spondylolisthesis.

1. Wiltse LL. The etiology of spondylolisthesis. J Bone Joint SurgAm. 1962;44-A:539-560.
2. Liu X, Wang L, Yuan S, et al. Multiple-level lumbar spondylolysisand spondylolisthesis. J Neurosurg Spine. 2015;22(3):283-287. doi:10.3171/2014.10.SPINE14415
3. Marnach ML, Ramin KD, Ramsey PS, Song SW, Stensland JJ,An KN. Characterization of the relationship between jointlaxity and maternal hormones in pregnancy. Obstet Gynecol.2003;101(2):331-335. doi: 10.1016/s0029-7844(02)02447-x
4. Kazemi S, Emami Razavi S Z, Azadvari M, et al. Frequencyevaluation of early pregnancy in spondylolisthesis: across sectional study on ıranian females. Arch Neurosci.2018;5(1):e15162. doi: 10.5812/archneurosci.15162
5. Suri P, Miyakoshi A, Hunter DJ, et al. Does lumbar spinaldegeneration begin with the anterior structures? A study of theobserved epidemiology in a community-based population. BMCMusculoskelet Disord. 2011;13;12:202. doi: 10.1186/1471-2474-12-202
6. Motley G, Nyland J, Jacobs J, Caborn DN. The pars interarticularisstress reaction, spondylolysis, and spondylolisthesis progression.J Athl Train. 1998;33(4):351-358.
7. Standaert CJ, Herring SA, Halpern B, King O. Spondylolysis. PhysMed Rehabil Clin N Am. 2000;11(4):785-803.
8. Roussouly P, Pinheiro-Franco JL. Biomechanical analysis of thespino-pelvic organization and adaptation in pathology. Eur SpineJ. 2011;20 Suppl 5(Suppl 5):609-618.
9. Hresko MT, Hirschfeld R, Buerk AA, Zurakowski D. The effectof reduction and instrumentation of spondylolisthesis onspinopelvic sagittal alignment. J Pediatr Orthop. 2009;29(2):157-162. doi: 10.1097/BPO.0b013e3181977de8
10. Cosgun Z, Dagistan E, Dagistan Y. Effects of sagittal balancediferences on spondylolisthesis. Acta Ortop Bras. 2019;27(2):120-123. doi: 10.1590/1413-785220192702205665
11. Leng Y, Tang C, He B, et al. Correlation between the spinopelvictype and morphological characteristics of lumbar facet jointsin degenerative lumbar spondylolisthesis. J Neurosurg Spine.2022;38(4):425-435. doi: 10.3171/2022.11.SPINE22979
12. Hsieh MK, Kao FC, Chen WJ, Chen IJ, Wang SF. The influence ofspinopelvic parameters on adjacent-segment degeneration aftershort spinal fusion for degenerative spondylolisthesis. J NeurosurgSpine. 2018;29(4):407-413. doi:10.3171/2018.2.SPINE171160
13. Tunckale T, Gurdal SO, Caliskan T, et al. The impact of variousbreast sizes of women on vertebral column and spinopelvicparameters. Turk Neurosurg. 2021;31(5):699-703. doi:10.5137/1019-5149.JTN.30936-20.2
14. Sawant n, Abraham M, George T, et al. Clinical, functionaland radiological spinopelvic balance parameters assessmentafter transforaminal lumbar interbody fusion in grade1 spondylolisthesis. Int Surg J. 2021;8(1):232-237. doi:10.18203/2349-2902.isj20205886
15. Haddas R, Kosztowski T, Mar D, et al. Balance effort, cone ofeconomy, and dynamic compensatory mechanisms in commondegenerative spinal pathologies. Gait Posture. 2021;89:67-73. doi:10.1016/j.gaitpost.2021.04.038
16. El-Daw, Sherif MD; El-Tantawy, et al. Role of machine learningin management of degenerative spondylolisthesis: a systematicreview. Curr Orthop Pract. 2021;32(3):302-308. doi: 10.1097/BCO.0000000000000992
17. Lazennec JY, Ramaré S, Arafati N, et al. Sagittal alignment inlumbosacral fusion: relations between radiological parameters andpain. Eur Spine J. 2000;9(1):47-55. doi: 10.1007/ s005860050008
18. Grobler LJ, Robertson PA, Novotny JE, et al. Etiology ofspondylolisthesis. Assessment of the role played by lumbar facetjoint morphology. Spine. 1993;18(1):80-91.
19. Legaye J. The femoro-sacral posterior angle: an anatomicalsagittal pelvic parameter usable with dome-shaped sacrum. EurSpine J. 2007;16(2):219-225. doi: 10.1007/s00586-006-0090-3
20. Liu H, Li S, Zheng Z, et al. Pelvic retroversion is the key protectivemechanism of L4-5 degenerative spondylolisthesis. Eur Spine J.2015;24(6):1204-1211. doi: 10.1007/s00586-014-3395-7
21. Funao H, Tsuji T, Hosogane N, et al. Comparative study ofspinopelvic sagittal alignment between patients with and withoutdegenerative spondylolisthesis. Eur Spine J. 2012;21(11):2181-2187. doi: 10.1007/s00586-012-2374-0
22. Kırcelli A, Coven ı, Sen P, et al. The effects of spinopelvicparameters such as lumbar lordosis and sacral slope angles in thedevelopment of lumbar disc degeneration. Bezmialem Sci. 2019;7(1):23-27. doi: 10.14235/bs.2018.2172
23. Ergun T, Lakadamyali H, Sahin M. The relation betweensagittal morphology of the lumbosacral spine and the degree oflumbar intervertebral disc degeneration. Acta Orthopaedica etTraumatologica Turcica. 2010;44(4):293-299.
24. Boulay C, Tardieu C, Hecquet J, et al. Anatomical reliability oftwo fundamental radiological and clinical pelvic parameters:incidence and thickness. Eur J Orthop Surg Traumatol. 2005;15(3):197-204.
25. Seitsalo S, Osterman K, Poussa M. Scoliosis associated withlumbar spondylolisthesis. A clinical survey of 190 young patients.Spine. 1988;13(8):899-904.
Volume 4, Issue 5, 2023
Page : 466-471