2012년 10월 13일 토요일

Clinical significance of lumbosacral kyphosis in adolescent spondylolisthesis

Deformity
Spine (Phila Pa 1976). 2012 Feb 15;37(4):304-8.

Title:
Clinical significance of lumbosacral kyphosis in adolescent spondylolisthesis


Authors


Study Design.

A cross-sectional study of 96 patients with lumbosacral adolescent spondylolisthesis

Objective.

1. Evaluate the association between lumbosacral kyphosis and quality of life

2. Identify reference values of LSK associated with significant impairments in quality of life



Summary of Background Data.

Unknown clinical impact even though LSK is considered an important aspect of deformity in adolescent spondylolisthesis


Methods.

1. 77 pats à low-grade/ 29 pats à high-grade adolescent lumbosacral spondylolisthesis

2. Three radiological parameters
à Slip angle (SA)
à Dubousset lumbosacral angle (Dub-LSA)
à Lumbosacral joint angle (LSJA)

3. Short Form Health Survey-12v2 questionnaire

4. Pearson correlations between each radiological parameter and the questionnaire scores




Results.

1. Significant correlations between 3 LSK parameters and the physical component summary of the Short Form Health Survey-12v2 (r = -0.55 for SA, 0.52 for Dub-LSA, and -0.55 for LSJA).

2. Stronger Correlations when calculated for high-grade patients only (r = -0.62 for SA, 0.56 for Dub-LSA, and -0.63 for LSJA).

3. Significant Correlations when controlling for slip percentage

4. Association between Values of 30°(SA), 80°(Dub-LSA), 30°(LSJA) and an increased proportion of subjects with poor physical component scores


Conclusion.

1. Significant correlation
àLSK & Physical aspect of the quality of life of adolescents with spondylolisthesis

2. Implication of abnormal LSK is particularly evident in high-grade spondylolisthesis.

3. All evaluated LSK parameters seem equivalent to measure this effect.

4. LSK should be routinely measured in adolescents with spondylolisthesis to fully appreciate the severity of the deformity and its clinical association with the quality of life of the patient.


Key Points
1. Significant correlation between LSK and a decline in the physical aspect of the quality of life.

2. The association between LSK and quality of life is particularly important in high-grade spondylolisthesis.

3. Lumbosacral kyphosis is an important aspect of the deformity and should be routinely measured during the evaluation of adolescents with lumbosacral spondylolisthesis.

"This comes from Spine (c) 2012 Lippincott Williams & Wilkins, Inc."