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Analysis of Spinopelvic Parameters in Lumbar Degenerative Kyphosis: Correlation With Spinal Stenosis and Spondylolisthesis

Lee, Jung-Hee, MD; Kim, Ki-Tack, MD; Suk, Kyung-Soo, MD; Lee, Sang-Hun, MD; Jeong, Bi-O, MD; Kim, Jin-Soo, MD; Eoh, Jae-Hyung, MD; Kim, Young-Jun, MD

doi: 10.1097/BRS.0b013e3181e88be6
Deformity
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Study Design. Retrospective study.

Objective. To define the relationship between pelvic parameters and lumbar spinal disorders including spinal stenosis, spondylolisthesis, and lumbar degenerative kyphosis (LDK).

Summary of Background Data. Although numerous studies have investigated the relationship between various lumbar spinal disorders and spinal parameters previously, none has reported on the relationship with LDK.

Methods. The present study analyzed 211 patients (163 females and 48 males) with spinal stenosis (n = 57), degenerative spondylolisthesis (n = 78), spondylolytic spondylolisthesis (n = 34), and LDK (n = 42). Lateral standing radiograph of the whole spine was analyzed with a dedicated software allowing calculation of the following parameters: pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), and sagittal vertical axis.

Results. Significant differences in the pelvic parameter were observed between the groups. The mean PI in males (49.6°) was less than that in females (57.3°) (P < 0.05). PI was found to be proportional to SS, PT, and LL (P < 0.001). PT was inversely proportional to TK and LL (P < 0.001). Analysis revealed the values of SS, LL, and TK to be significantly higher and those of PT and the PT/PI ratio to be significantly lower in LDK than in the other groups. Values of PI, SS, and LL, but not PT, were significantly higher in subjects of LDK with Takemitsu type 1 than in those with type 2. PI was shown to possess statistically significant correlation to SS, PT, LL, and PT/PI ratio but not to TK or sagittal vertical axis.

Conclusion. PI has a direct influence on the variable lumbar curvature in LDK. PI and SS may be complementary factors in determining the subtype of LDK, as PT appears to be relatively constant between the different subtypes of LDK.

Analysis of spinopelvic parameters in lumbar degenerative kyphosis revealed sacral slope, lumbar lordosis, and thoracic kyphosis to be lower and pelvic tilt to be higher compared with the other groups. Pelvic incidence and lumbar lordosis were higher, but pelvic tilt was not, in Takemitsu type 1 lumbar degenerative kyphosis when compared with type 2.

From the Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

Acknowledgment date: February 3, 2010. Revision date: April 20, 2010. Acceptance date: April 26, 2010.

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 Jung-Hee Lee, MD, Department of Orthopaedic Surgery, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130–702, Korea; E-mail: ljhspine@gmail.com

© 2010 Lippincott Williams & Wilkins, Inc.