Radiographic parameter differences in degenerative scoliosis with/without degenerative lumbar spondylolisthesis.

Abstract

To investigate the imaging differences between degenerative scoliosis (DS) with or without degenerative lumbar spondylolisthesis (DLS). 124 patients who underwent DS correction were enrolled in this study. Group A comprised 58 patients with DS with DLS, and group B comprised 66 patients with DS without DLS. Preoperative, postoperative, and 2-year follow-up coronal and sagittal imaging parameters were measured. The patients were classified in accordance with the SRS-Schwab classification, Schwab classification, and modified Abelin-Genevois classification. Clinical outcomes were evaluated using Japanese Orthopaedic Association (JOA) scores, visual analog scale (VAS) scores for pain, and the Oswestry disability index (ODI) scores. The primary affected vertebrae in group A were the L3/4 segment (53.4%), whereas in group B, the L2/3 or L3/4 segments (42.4% and 39.3%, respectively) were affected. In the Schwab classification, most patients in group A were classified as type III, and most patients in group B were classified as type II (P < 0.05). In the modified Abelin-Genevois classification, most patients in group A were classified as grade AG4, but group B were most classified as grade AG3 (P < 0.05). Preoperative CVA, Cobb angle, apical vertical rotation, and SVA were larger in group A than those in group B, whereas LL and DH were smaller (P < 0.05). Preoperative Cobb angle, CVA, and SVA were larger in patients with grade II spondylolisthesis in group A, whereas LL was smaller(P < 0.05). Compared with DS without DLS, DS with DLS is associated with greater preoperative coronal and sagittal imbalance; larger CVA, SVA, and Cobb angle; and smaller LL. Differences in CVA, SVA, Cobb angle, and LL were more obvious with high DS severity.