BIOMECHANICAL ANALYSIS AND CLASSIFICATION OF LUMBOSACRAL SPONDYLOLISTHESIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GONG Quan , KONG Qingquan.

Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China. Corresponding author: KONG Qingquan, E-mail: kongspine@126.com;

Corresponding author：

Keywords：

Lumbosacral spondylolisthesis; Sagittal balance; Classification standard Pelvic incidence; Pelvic tilt

DOI：

10.7507/1002-1892.20130247

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Objective To review the research progress of the risk factors for slip progression and the pathogenesis of lumbosacral spondylolisthesis, and to discuss the value of Spinal Deformity Study Group (SDSG) classification system for lumbosacral spondylolisthesis. Methods Recent articles about the risk factors for slip progression and the pathogenesis of lumbosacral spondylolisthesis were reviewed and comprehensively analyzed with SDSG classification system of lumbosacral spondylolisthesis. Results Pelvic incidence (PI) is the key pathogenic factor of lumbosacral spondylolisthesis. The Meyerding grade of slip, PI, sacro-pelvic balance, and spino-pelvic balance not only are the fundamental risk factors of slip progression, but also are the key factors to determine how to treat and influence the prognosis. Therefore, compared with Wiltse, Marchetti-Bartolozzi, and Mac-Thiong-Labelle classification systems of lumbosacral spondylolisthesis, SDSG classification based on these factors mentioned above, has better homogeneity between the subjects of subgroup, and better reliability, moreover, could better guide operative plan and judge the prognosis. Conclusion It is suggested that the SDSG classification system should be the standard classification for lumbosacral spondylolisthesis for the clinical and research work.

Citation： GONG Quan,KONG Qingquan.. BIOMECHANICAL ANALYSIS AND CLASSIFICATION OF LUMBOSACRAL SPONDYLOLISTHESIS. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(9): 1134-1137. doi: 10.7507/1002-1892.20130247 Copy

1.	Wiltse LL, Newman PH, Macnab I. Classification of spondylolisis and spondylolisthesis. Clin Orthop Relat Res, 1976, (117): 23-29.
2.	Marchetti PG, Bartolozzi P. Classification of spondylolisthesis as a guideline for treatment//Bridwell K, DeWald R. The textbook of spinal surgery. 2nd ed. Philadelphia: Lippincott-Raven, 1997: 1211-1254.
3.	Hammerberg KW. New concepts on the pathogenesis and classification of spondylolisthesis. Spine (Phila Pa 1976), 2005, 30(Suppl 6): S4-11.
4.	McCarty ME, Mehlman CT, Tamai J, et al. Spondylolisthesis: intraobserver and interobserver reliability with regard to the measurement of slip percentage. J Pediatr Orthop, 2009, 29(7): 755-759.
5.	Lamartina C, Zavatsky JM, Petruzzi M, et al. Novel concepts in the evaluation and treatment of high-dysplastic spondylolisthesis. Eur Spine J, 2009, 18 Suppl 1: 133-142.
6.	Mac-Thiong JM, Wang Z, de Guise JA, et al. Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis. Spine (Phila Pa 1976), 2008, 33(21): 2316-2325.
7.	Labelle H, Roussouly P, Berthonnaud E, et al. Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine (Phila Pa 1976), 2004, 29(18): 2049-2054.
8.	Debarge R, Demey G, Roussouly P. Sagittal balance analysis after pedicle subtraction osteotomy in ankylosing spondylitis. Eur Spine J, 2011, 20(Suppl 5): 619-625.
9.	Li W, Sun Z, Guo Z, et al. Analysis of spino-pelvic sagittal alignment in patients with thoracic and thoracolumbar angular kyphosis. Spine (Phila Pa 1976), 2013. [Epub ahead of print].
10.	Farcy JP, Schwab FJ. Management of flatback and related kyphotic decompensation syndromes. Spine (Phila Pa 1976), 1997, 22(20): 2452-2457.
11.	Roussouly P, Pinheiro-Franco JL. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J, 2011, 20 Suppl 5: 609-618.
12.	Labelle H, Mac-Thiong JM, Roussouly P. Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J, 2011, 20 Suppl 5: 641-646.
13.	Schwab F, Lafage V, Patel A, et al. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976), 2009, 34(17): 1828-1833.
14.	Berthonnaud E, Dimnet J, Roussouly P, et al. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech, 2005, 18(1): 40-47.
15.	Boulay C, Tardieu C, Hecquet J, et al. Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J, 2006, 15(4): 415-422.
16.	Barrey C, Jund J, Perrin G, et al. Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery, 2007, 61(5): 981-986.
17.	Hresko MT, Labelle H, Roussouly P, et al. Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction. Spine (Phila Pa 1976), 2007, 32(20): 2208-2213.
18.	Mac-Thiong JM, Labelle H. A proposal for a surgical classification of pediatric lumbosacral spondylolisthesis based on current literature. Eur Spine J, 2006, 15(10): 1425-1435.
19.	Mac-Thiong JM, Labelle H, Parent S, et al. Reliability and development of a new classification of lumbosacral spondylolisthesis. Scoliosis, 2008, 3: 19.
20.	Roussouly P, Gollogly S, Berthonnaud E, et al. Sagittal alignment of the spine and pelvis in the presence of L5-S1 isthmic lysis and low-grade spondylolisthesis. Spine (Phila Pa 1976), 2006, 31(21): 2484-2490.
21.	Mac-Thiong JM, Duong L, Parent S, et al. Reliability of the Spinal Deformity Study Group classification of lumbosacral spondylolisthesis. Spine (Phila Pa 1976), 2012, 37(2): E95-102.
22.	Harroud A, Labelle H, Joncas J, et al. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis. Eur Spine J, 2013, 22(4): 849-856.

1. Wiltse LL, Newman PH, Macnab I. Classification of spondylolisis and spondylolisthesis. Clin Orthop Relat Res, 1976, (117): 23-29.
2. Marchetti PG, Bartolozzi P. Classification of spondylolisthesis as a guideline for treatment//Bridwell K, DeWald R. The textbook of spinal surgery. 2nd ed. Philadelphia: Lippincott-Raven, 1997: 1211-1254.
3. Hammerberg KW. New concepts on the pathogenesis and classification of spondylolisthesis. Spine (Phila Pa 1976), 2005, 30(Suppl 6): S4-11.
4. McCarty ME, Mehlman CT, Tamai J, et al. Spondylolisthesis: intraobserver and interobserver reliability with regard to the measurement of slip percentage. J Pediatr Orthop, 2009, 29(7): 755-759.
5. Lamartina C, Zavatsky JM, Petruzzi M, et al. Novel concepts in the evaluation and treatment of high-dysplastic spondylolisthesis. Eur Spine J, 2009, 18 Suppl 1: 133-142.
6. Mac-Thiong JM, Wang Z, de Guise JA, et al. Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis. Spine (Phila Pa 1976), 2008, 33(21): 2316-2325.
7. Labelle H, Roussouly P, Berthonnaud E, et al. Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine (Phila Pa 1976), 2004, 29(18): 2049-2054.
8. Debarge R, Demey G, Roussouly P. Sagittal balance analysis after pedicle subtraction osteotomy in ankylosing spondylitis. Eur Spine J, 2011, 20(Suppl 5): 619-625.
9. Li W, Sun Z, Guo Z, et al. Analysis of spino-pelvic sagittal alignment in patients with thoracic and thoracolumbar angular kyphosis. Spine (Phila Pa 1976), 2013. [Epub ahead of print].
10. Farcy JP, Schwab FJ. Management of flatback and related kyphotic decompensation syndromes. Spine (Phila Pa 1976), 1997, 22(20): 2452-2457.
11. Roussouly P, Pinheiro-Franco JL. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J, 2011, 20 Suppl 5: 609-618.
12. Labelle H, Mac-Thiong JM, Roussouly P. Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J, 2011, 20 Suppl 5: 641-646.
13. Schwab F, Lafage V, Patel A, et al. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976), 2009, 34(17): 1828-1833.
14. Berthonnaud E, Dimnet J, Roussouly P, et al. Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech, 2005, 18(1): 40-47.
15. Boulay C, Tardieu C, Hecquet J, et al. Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J, 2006, 15(4): 415-422.
16. Barrey C, Jund J, Perrin G, et al. Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery, 2007, 61(5): 981-986.
17. Hresko MT, Labelle H, Roussouly P, et al. Classification of high-grade spondylolistheses based on pelvic version and spine balance: possible rationale for reduction. Spine (Phila Pa 1976), 2007, 32(20): 2208-2213.
18. Mac-Thiong JM, Labelle H. A proposal for a surgical classification of pediatric lumbosacral spondylolisthesis based on current literature. Eur Spine J, 2006, 15(10): 1425-1435.
19. Mac-Thiong JM, Labelle H, Parent S, et al. Reliability and development of a new classification of lumbosacral spondylolisthesis. Scoliosis, 2008, 3: 19.
20. Roussouly P, Gollogly S, Berthonnaud E, et al. Sagittal alignment of the spine and pelvis in the presence of L5-S1 isthmic lysis and low-grade spondylolisthesis. Spine (Phila Pa 1976), 2006, 31(21): 2484-2490.
21. Mac-Thiong JM, Duong L, Parent S, et al. Reliability of the Spinal Deformity Study Group classification of lumbosacral spondylolisthesis. Spine (Phila Pa 1976), 2012, 37(2): E95-102.
22. Harroud A, Labelle H, Joncas J, et al. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis. Eur Spine J, 2013, 22(4): 849-856.

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Chinese Journal of Reparative and Reconstructive Surgery

BIOMECHANICAL ANALYSIS AND CLASSIFICATION OF LUMBOSACRAL SPONDYLOLISTHESIS

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