Biomechanical evaluation of predictive parameters of progression in adolescent isthmic spondylolisthesis: a computer modeling and simulation study

Scoliosis

Hubert Labelle¹  Xiaoyu Wang²  Hicham Gharbi¹  Carl-Eric Aubin¹  Amandine Sevrain¹ 

[1] Research Center, Sainte-Justine University Hospital Center of Universite de Montreal, 3175, Cote Sainte-Catherine Rd, Montréal (Québec), H3T 1C5 CANADA;École Polytechnique, Universite de Montreal, P.O. Box 6079, Station Centre-Ville, Montréal (Québec), H3C 3A7 CANADA

关键词: biomechanical model;    pelvic incidence;    finite element model;    Isthmic spondylolisthesis;   

Others  :  791733
DOI  :  10.1186/1748-7161-7-2

 received in 2011-10-04, accepted in 2012-01-18,  发布年份 2012

【 摘 要 】

Background

Pelvic incidence, sacral slope and slip percentage have been shown to be important predicting factors for assessing the risk of progression of low- and high-grade spondylolisthesis. Biomechanical factors, which affect the stress distribution and the mechanisms involved in the vertebral slippage, may also influence the risk of progression, but they are still not well known. The objective was to biomechanically evaluate how geometric sacral parameters influence shear and normal stress at the lumbosacral junction in spondylolisthesis.

Methods

A finite element model of a low-grade L5-S1 spondylolisthesis was constructed, including the morphology of the spine, pelvis and rib cage based on measurements from biplanar radiographs of a patient. Variations provided on this model aimed to study the effects on low grade spondylolisthesis as well as reproduce high grade spondylolisthesis. Normal and shear stresses at the lumbosacral junction were analyzed under various pelvic incidences, sacral slopes and slip percentages. Their influence on progression risk was statistically analyzed using a one-way analysis of variance.

Results

Stresses were mainly concentrated on the growth plate of S1, on the intervertebral disc of L5-S1, and ahead the sacral dome for low grade spondylolisthesis. For high grade spondylolisthesis, more important compression and shear stresses were seen in the anterior part of the growth plate and disc as compared to the lateral and posterior areas. Stress magnitudes over this area increased with slip percentage, sacral slope and pelvic incidence. Strong correlations were found between pelvic incidence and the resulting compression and shear stresses in the growth plate and intervertebral disc at the L5-S1 junction.

Conclusions

Progression of the slippage is mostly affected by a movement and an increase of stresses at the lumbosacral junction in accordance with spino-pelvic parameters. The statistical results provide evidence that pelvic incidence is a predictive parameter to determine progression in isthmic spondylolisthesis.

【 授权许可】

   
2012 Sevrain et al; licensee BioMed Central Ltd.

【 图 表 】

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