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Changes in spino-pelvic alignment after surgical treatment of high-grade isthmic spondylolisthesis by a posterior approach: a report of 41 cases
Authors:Faldini  Cesare  Di Martino  Alberto  Perna  Fabrizio  Martikos  Kostantinos  Greggi  Tiziana  Giannini  Sandro
Affiliation:1.Department of General Orthopaedics, Department Rizzoli Sicilia, Istituto Ortopedico Rizzoli di Bologna, University of Bologna, Bologna, Italy
;2.CIR, Center of Integrated Research, Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy
;3.Department of Spinal Deformity Surgery, Istituto Ortopedico Rizzoli di Bologna, Bologna, Italy
;4.I Clinica Ortopedica; Istituto Ortopedico Rizzoli di Bologna, University of Bologna, Bologna, Italy
;
Abstract:Purpose

To analyze changes in spino-pelvic parameters (SPPs) after surgery of high-grade lumbar isthmic spondylolisthesis (HDIS).

Methods

We analyzed 41 patients affected by HDIS operated upon by attempt of reduction and posterior spinal fusion with pedicle screw systems with or without interbody fusion. Pelvic tilt (PT), lumbar lordosis (LL), pelvic incidence (PI), and sacral slope (SS) were measured, and patients were further divided into balanced and unbalanced pelvis subgroups.

Results

SS passed from 46.8° ± 9.8° preoperatively to 50.1° ± 10.1° (p = 0.02). PT passed from 26.7° ± 6.7° preoperatively to 22.9° ± 7.5° (p = 0.003). Unbalanced patients showed significantly higher PT and lower SS compared to the balanced patients preoperatively, and these corrected after surgery. Patients with instrumentation failure (n = 5) had significant increase in PT values postoperatively (p = 0.018).

Conclusions

We confirmed the positive effect of surgery on the SPPs in patients affected by HDIS, which showed different patterns of corrections with surgery for balanced and unbalanced pelvis patients.

Keywords:
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