gms | German Medical Science

German Congress of Orthopaedics and Traumatology (DKOU 2016)

25.10. - 28.10.2016, Berlin

Does Concomitant Isthmic Spondylolisthesis Influence the Curve Pattern of Scoliosis?

Meeting Abstract

  • presenting/speaker Dietrich Schlenzka - ORTON Research Institute, Helsinki, Finland
  • Mauno Ylikoski - ORTON Research Institute, Helsinki, Finland
  • Timo Yrjönen - ORTON Orthopaedic Hospital, Helsinki, Finland
  • Teija Lund - ORTON Research Institute, Helsinki, Finland
  • Heikki Österman - ORTON Orthopaedic Hospital, Helsinki, Finland
  • Mikko Poussa - ORTON Orthopaedic Hospital, Helsinki, Finland

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016). Berlin, 25.-28.10.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocPO26-1465

doi: 10.3205/16dkou740, urn:nbn:de:0183-16dkou7409

Published: October 10, 2016

© 2016 Schlenzka et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: Scoliosis and isthmic spondylolisthesis in the same patient is not uncommon. In the literature, percentages between 14 and 43 have been reported. The true incidence is unknown. It is further unknown whether there is a causal relationship between the two pathologies.

The purpose of this study was to investigate if the presence of an isthmic slip has an influence on the curve type of the scoliosis.

Methods: Out of 1641 consecutive scoliosis patients who underwent spinal radiography, 141 (8.6%) were found to have an L5 isthmic slip. The mean slip was 19±17.8% measured from long standing lateral radiographs of the spine according to Laurent and Einola. All radiographic measurements were performed by the same experienced spinal radiologist.

This is a retrospective comparison of two cohorts: 1500 patients with scoliosis only (SC-Group) and 141 with scoliosis and spondylolisthesis (SP-Group).

Results and Conclusion: The age at diagnosis was 13.9±1.9 years in the SC-Group; in the SP-Group it was 13.6±1.8 years. The gender distribution (female / male) was 86.0 / 14.0% and 81.6 / 18.4% respectively.

The Cobb angle of the primary curve was 27.9±12.5° in the SC-Group and 26.5±12.1° in the SP-Group.

The distribution of the curve types (thoracic / thoraco-lumbar / lumbar) comparing SC and SP was as follows: thoracic curves 61.9 vs. 63.1%, thoracolumbar curves 24.7 vs. 27.7%, lumbar curves 13.4 vs. 9.2%.

None of the differences between SC and SP reached statistical significance.

Out of the 141 patients with spondylolisthesis and scoliosis, 54 patients did not have any treatment at all, 50 underwent bracing for the scoliosis, one patient had an orthosis for a symptomatic L5 slip, 35 patients underwent surgery: 22 for spondylolisthesis, 11 for scoliosis, and two for both.

The percentage of scoliosis patients having L5 isthmic spondylolisthesis was lower than figures presented in the literature but higher than in the general population. The presence of an isthmic L5 slip did not seem to influence the curve pattern of the scoliosis. However, further studies including scoliosis progression, sidedness, and clinical outcome are necessary.