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Anatomic Changes in Lateral Spondylolisthesis Associated with Adult Lumbar Scoliosis

Toyone, Tomoaki, MD*; Tanaka, Tadashi, MD; Kato, Daisuke, MD; Kaneyama, Ryutaku, MD; Otsuka, Makoto, MD

doi: 10.1097/01.brs.0000186581.44715.df
Deformity
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Study Design. Prospective consecutive series.

Objective. To analyze the anatomic changes in lateral spondylolisthesis.

Summary of Background Data. Previous studies have focused on the correlation between lateral spondylolisthesis, and curve progression and pain. To our knowledge, there has not been any detailed report concerning anatomic changes in lateral spondylolisthesis.

Methods. We examined 24 consecutive patients (mean age 66 years), with lateral spondylolisthesis associated with lumbar scoliosis who had computerized tomography (CT) after myelography. Coronal reconstruction CT was used to measure the vertebral translation. Vertebral rotation was measured by the Aaro method using transaxial CT.

Results. The Cobb angle averaged 26° (range 13°–75°). Lateral spondylolisthesis was found most commonly at the lower-end vertebra. The cephalad-slipped vertebra rotated toward the convex side of the main curve, whereas the caudal vertebra rotated toward the convex side of the lumbosacral hemi (or fractional) curve below. Mean lateral translation and vertebral rotation were 7 mm and 8°, respectively. There was a significant correlation between lateral translation and vertebral rotation (r = 0.49; P = 0.018). The convex superior articular process of the caudal vertebra had compressed the nerve root laterally in 21 patients, of whom 10 had radicular pain. The concave, inferior articular process of the cephalad vertebra had compressed the dural sac posteriorly, and 2 patients had radicular pain.

Conclusions. To our knowledge, this study has been the first attempt to analyze anatomic changes in lateral spondylolisthesis using CT. It may offer further insight into the pathogenesis of adult lumbar scoliosis.

The cephalad-slipped vertebra rotated toward the convex. Mean lateral translation and vertebral rotation were 7 mm and 8°, respectively. There was a significant correlation between lateral translation and vertebral rotation. The convex superior articular process of the caudal vertebra had compressed the nerve root laterally.

From the *Department of Orthopaedic Surgery, Teikyo University School of Medicine, Ichihara Hospital, Ichihara-city, and †Division of Orthopaedic Surgery, Kimitsu Chuo Hospital, Kisarazu-city, Japan.

Acknowledgment date: January 31, 2005. First revision date: May 1, 2005. Second revision date: May 31, 2005. Acceptance date: June 1, 2005.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Tomoaki Toyone, MD, Department of Orthopaedic Surgery, Teikyo University School of Medicine, Ichihara Hospital, 3426-3 Anesaki, Ichihara-city, Chiba 299-0111, Japan; E-mail: tomotomot2001@aol.com

© 2005 Lippincott Williams & Wilkins, Inc.