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

Objective: To investigate the imaging differences between degenerative scoliosis (DS) with or without degenerative lumbar spondylolisthesis (DLS).

Methods: 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.

Results: 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).

Conclusion: 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.