요추 전방전위증에서 전위정도와 전위각이 요추 전만과 체간 균형에 미치는 영향 = Influences of Slip Amount and Slip Angle on Lumbar Lordosis and Sagittal Balance in Lumbar Spondylolisthesis

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the influences of slip percent and slip angle on sagittal balance and its parameters in lumbar spondylolisthesis.
Materials and Methods: 41 patients of lumbar spondylolisthesis surgically treated were evaluated using 14×36 inch standing lateral films. The global sagittal balance was measured with C7 plumb-line. Using correlation statistics, the influences of slip percent and slip angle on C7 plumb-line, lumbar lordosis, thoracic kyphosis and pelvic tilting angle were evaluated.
Results: All patients except 4 showed global compensation state with anteriorly shifted C7 plumb-line of +3.4㎝(±3.9,SD). The all 4 decompensated patients were in non-lytic type, showing higher probability of imbalance of non-lytic type compared to lytic type(Fisher's exact test. p=0.011). In partial correlation adjusting for age, the slip angle revealed significant correlations with lumbar lordosis(r=-0.66, p=0.000), thoracic kyphosis(r=-0.57, p=0.000) and C7 plumb-line(r=0.53, p=0.002), respectively, but the percent slip had no significant correlations with them. The correlation between slip angle and pelvic tilting was quadratic relationship(R2=0.44).
Conclusion : The slip angle had significant influences on lumbar lordosis, pelvic tilting and C7 plumb line, but the slip percent had no influence on them, in spondylolisthesis. So, in sagittal balance evaluation and treatment planning, the slip angle should be considered as more important factor than slip percent.