Skip to main content
SpringerLink
Log in

A morphometric analysis of all lumbar intervertebral discs and vertebral bodies in degenerative spondylolisthesis

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Most morphometric studies on lumbar degenerative spondylolisthesis (DS) have focused solely on the L4–L5 slipped level, neglecting the shape of the entire lumbar segments. The purpose of this study was to present a morphometric analysis of the entire lumbar IVDs and VBs in DS.

Methods

Out of 500 lumbar CTs, the first 100 CTs, 50 with DS at L4 and 50 age- and sex-matched control CTs, were randomly selected. All lumbar IVD and VB heights, widths, lengths and sagittal wedging as well as lumbar lordosis (LL) and sacral inclination (SI) were measured and relevant ratios calculated. The prevalence of lumbar vertebral osteophyte was also measured.

Results

A total of 6700 measurements were taken. Age, height, weight and BMI had no effect on all parameters. Compared with controls, in females with DS, the majority of IVDs were flatter, with increased kyphotic wedging at L1–L2 (Δ1.3°) and L2–L3 (Δ1.8°), turning to lordotic wedging at L3–L4 (Δ5.9°), and decreased lordotic wedging at L4–L5 (Δ2.7°) and L5–S1 (Δ5.3°). The posterior IVD/VB ratio of all lumbar levels, middle IVD/VB ratio of L3–S1 and anterior IVD/VB ratio of L4–S1 were smaller. In males with DS, the L2–L3 IVD manifested more kyphotic wedging (Δ3.8°), the L4 VB wedging was more lordotic (Δ2.4°) and all L4–L5 IVD/VB ratios and L3–L4 middle and posterior IVD/VB ratios were smaller.

Conclusions

Individuals with DS have a more generalized degenerative disc disease on all lumbar vertebral levels, characterized by decreased disc space heights and kyphotic posture of the upper lumbar segments, occurring more predominantly in females than in males with DS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Markwalder M (1993) Surgical management of neurogenic claudication in 100 patients with lumbar spinal stenosis due to degenerative spondylolisthesis. Acta Neurochir (Wien) 120:136–142

    Article  CAS  Google Scholar 

  2. Drury T, Ames SE, Costi K et al (2009) Degenerative spondylolisthesis in patients with neurogenic claudication effects functional performance and self-reported quality of life. Spine 34:2812–2817

    Article  PubMed  Google Scholar 

  3. Hasegewa K, Kitahara K, Hara T et al (2009) Biomechanical evaluation of segmental instability in degenerative lumbar spondylolisthesis. Eur Spine J 18:465–470

    Article  PubMed  Google Scholar 

  4. Hasegawa K, Shimoda H, Kitahara K et al (2011) What are the reliable radiological indicators of lumbar segmental instability? J Bone Joint Surg Br 93:650–657

    Article  CAS  PubMed  Google Scholar 

  5. Jacobsen S, Sonne-Holm S, Rovsing H et al (2007) Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study. Spine 32:120–125

    Article  PubMed  Google Scholar 

  6. Iguchi T, Wakami T, Kurihara A, et al 9 (2002) Lumbar multilevel degenerative spondylolisthesis: radiological evaluation and factors related to anterolisthesis and retrolisthesis. J Spinal Disord Tech 15:93–99

  7. Imada K, Matsui H, Tsuji H (1995) Oophorectomy predisposes to degenerative spondylolisthesis. J Bone Joint Surg Br 77:126–130

    CAS  PubMed  Google Scholar 

  8. Hosoe H, Ohmori K (2008) Degenerative lumbosacral spondylolisthesis: possible factors which predispose the fifth lumbar vertebra to slip. J Bone Joint Surg Br 90:356–359

    Article  CAS  PubMed  Google Scholar 

  9. Barrey C, Jund J, Perrin G et al (2007) Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery 61:981–986

    Article  PubMed  Google Scholar 

  10. Legaye J, Duval-Beaupère G, Hecquet J et al (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7:99–103

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Roussouly P, Pinheiro-Franco J (2011) Sagittal parameters of the spine: biomechanical approach. Eur Spine J 20:578–585

    Article  PubMed  PubMed Central  Google Scholar 

  12. Been E, Ling L, Hunter D et al (2011) Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study. Eur Spine J 20:1159–1165

    Article  PubMed  Google Scholar 

  13. Chen I, Wei T (1976) Disc height and lumbar index as independent predictors of degenerative spondylolisthesis in middle-aged women with low back pain. Spine 34:1402–1409

    Article  Google Scholar 

  14. Berlemann U, Jeszenszky DJ, Buhler DW et al (1999) The role of lumbar lordosis, vertebral end-plate inclination, disc height, and facet orientation in degenerative spondylolisthesis. J Spinal Disord 12:68–73

    Article  CAS  PubMed  Google Scholar 

  15. Funao H, Tsuji T, Hosogane N et al (2012) Comparative study of spinopelvic sagittal alignment between patients with and without degenerative spondylolisthesis. Eur Spine J 21:2181–2187

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kirkaldy-Willis WH, Wedge JH, Yong-Hing K et al (1978) Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine 3:319–328

    Article  CAS  PubMed  Google Scholar 

  17. Kalichman L, Kim DH, Li L et al (2009) Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine 34:199–205

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sanderson P, Fraser R (1996) The influence of pregnancy on the development of degenerative spondylolisthesis. J Bone Joint Surg Br 78:951–954

    Article  CAS  PubMed  Google Scholar 

  19. Farfan HF (1980) The pathological anatomy of degenerative spondylolisthesis: a cadaver study. Spine 5:412–418

    Article  CAS  PubMed  Google Scholar 

  20. Rosenberg N (1975) Degenerative spondylolisthesis: Predisposing factors. J Bone Joint Surg Am 57:467–474

    CAS  PubMed  Google Scholar 

  21. Cinotti G, Postacchini F, Fassari F et al (1997) Predisposing factors in degenerative spondylolisthesis. A radiographic and CT study. Int Orthop 21:337–342

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Belfi L, Ortiz A, Katz D (2006) Computed tomography evaluation of spondylolysis and spondylolisthesis in asymptomatic patients. Spine 15:E907–E910

    Article  Google Scholar 

  23. Saint-Louis L (2001) Lumbar spinal stenosis assessment with computed tomography, magnetic resonance imaging and myelography. Clin Orthop Relat Res 384:122–136

    Article  PubMed  Google Scholar 

  24. Paul C, Hansen A (1982) computed tomography in spondylolisthesis. Clin Orthop Relat Res 6:62–71

    Google Scholar 

  25. Schuller S, Charles Y, Steib J (2011) Sagittal spinopelvic alignment and body mass index in patients with degenerative spondylolisthesis. Eur Spine J 20:713–719

    Article  PubMed  Google Scholar 

  26. Chen IR, Wei TS (2009) Disc height and lumbar index as independent predictors of degenerative spondylolisthesis in middle-aged women with low back pain. Spine 34:1402–1409

    Article  PubMed  Google Scholar 

  27. Galbsura F, Schmidt H, Neidliniger-Wilke C et al (2011) The effect of degenerative morphological changes of the intervertebral disc on the lumbar spine biomechanics: a poroelastic finite element investigation. Comput Methods Biomech Biomed Eng 14:729–739

    Article  Google Scholar 

  28. Roussouly P, Gollogly S, Berthonnaud E et al (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine 30:346–353

    Article  PubMed  Google Scholar 

  29. Korez R, Likar B, Pernus F et al (2014) Parametric modeling of the intervertebral disc space in 3D: application to CT images of the lumbar spine. Comput Med Imaging Graph 38:596–605

    Article  PubMed  Google Scholar 

  30. Merckaert S, Pierzchala K, Kulik G et al (2015) Influence of anatomical variations on lumbar foraminal stenosis pathogenesis. Eur Spine J 24:313–318

    Article  PubMed  Google Scholar 

  31. Smorgick Y, Mirovsky Y, Fischgrund JS et al (2014) Radiographic predisposing factors for degenerative spondylolisthesis. Orthopedics 37:260–264

    Article  Google Scholar 

  32. Maatta JH, Kraatari M, Wolber L et al (2014) Vertebral endplate change as a feature of intervertebral disc degeneration: a heritability study. Eur Spine J 23:1856–1862

    Article  PubMed  Google Scholar 

  33. Miao J, Wang S, Park WM et al (2013) Segmental spinal canal volume in patients with degenerative spondylolisthesis. Spine J 13:706–712

    Article  PubMed  PubMed Central  Google Scholar 

  34. Dai L (2001) Orientation and tropism of lumbar facet joints in degenerative spondylolisthesis. Int Orthop 25:40–42

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Toyone T, Moriya H, Kitahara H, Takahashi K, Yamagata M, Murakami M, Takahashi Y (1993) Assessment of segmental spinal instability using magnetic resonance imaging. In: Yonenobu K, Ono Y, Takemitsu Y (eds) Lumbar fusion and stabilization. Springer- Verlag, Tokyo, pp 35–44

    Chapter  Google Scholar 

  36. Masharawi Y, Alperovitch-Najenson D, Steinberg N et al (2007) Lumbar facet orientation in spondylolysis: a skeletal study. Spine 6:176–180

    Article  Google Scholar 

  37. Masharawi Y, Peleg S, Nili S et al (2007) Lumbar facet anatomy changes in spondylolysis: a comparative skeletal study. Eur Spine J 16:993–997

    Article  PubMed  PubMed Central  Google Scholar 

  38. Matsunaga S, Sakou T, Morizono Y et al (1990) Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage. Spine 15:1204–1210

    Article  CAS  PubMed  Google Scholar 

  39. Newman P (1955) Spondylolisthesis, its cause and effect. Ann R Coll Surg Engl 16:305–323

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Love T, Fagan A, Fraser R (1999) Degenerative spondylolisthesis developmental or acquired. J Bone Joint Surg Br 81:670–674

    Article  CAS  PubMed  Google Scholar 

  41. Boden S, Riew K, Yamaguchi K et al (1996) Orientation of the lumbar facet joints: association with degenerative disc disease. J Bone Joint Surg Am 78:403–411

    CAS  PubMed  Google Scholar 

  42. Sato K, Wakamatsu E, Yoshizumi A et al (1989) The configuration of the laminas and facet joints in degenerative spondylolisthesis: a clinicoradiologic study. Spine 14:1265–1271

    Article  CAS  PubMed  Google Scholar 

  43. Kalichman L, Suri P, Guermazi A et al (2009) Facet orientation and tropism: associations with facet joint osteoarthritis and degeneratives. Spine 34:E579–E585

    Article  PubMed  PubMed Central  Google Scholar 

  44. Haruki F, Takashi T, Naobumi H et al (2012) Comparative study of spinopelvic sagittal alignment between patients with and without degenerative spondylolisthesis. Eur Spine J 21:2181–2187

    Article  Google Scholar 

  45. Grobler L, Robertson P, Novotny J et al (1993) Etiology of spondylolisthesis. Assessment of the role played by lumbar facet joint morphology. Spine 18:80–91

    Article  CAS  PubMed  Google Scholar 

  46. Anekstein Y, Floman Y, Smorgick Y et al (2015) Seven years follow-up for total lumbar facet joint replacement (TOPS) in the management of lumbar spinal stenosis and degenerative spondylolisthesis. Eur Spine J 24:2306–2314

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Spinal Research Laboratory, Department of Physical Therapy, Sackler Faculty of Medicine, The Stanley Steyer School of Health Professions, Tel-Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel

    Saher Abu-Leil & Youssef Masharawi

  2. Israel Spine Center, Assuta Hospital, Habarzel St 20, Tel Aviv, Israel

    Yizhar Floman

  3. Department of Orthopedic Surgery, Wolfson Medical Center, Ha-Lokhamim St 62, Holon, Israel

    Yigal Bronstein

Authors
  1. Saher Abu-Leil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yizhar Floman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yigal Bronstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Youssef Masharawi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Youssef Masharawi.

Ethics declarations

Conflict of interest

None.

Additional information

The authors thank Mrs. Phyllis Curchack Kornspan for her editorial assistance.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abu-Leil, S., Floman, Y., Bronstein, Y. et al. A morphometric analysis of all lumbar intervertebral discs and vertebral bodies in degenerative spondylolisthesis. Eur Spine J 25, 2535–2545 (2016). https://doi.org/10.1007/s00586-016-4673-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-016-4673-3

Keywords

Search

Navigation