Correlation analysis between correction of lumbosacral kyphosis deformity and quality of life of patients with high-grade L5 dysplastic spondylolisthesis

English Keywords:Spondylolisthesis  High-grade dysplastic  Lumbosacral kyphosis  Correction  Quality of life

English Abstract:

  【Abstact】 Objectives: To analyze the effect of correction of lumbosacral kyphosis deformity on the quality of life of patients with high-grade L5/S1 dysplastic spondylolisthesis. Methods: To retrospectively analyze the data of 31 patients diagnosed with high-grade L5 dysplastic spondylolisthesis and treated with reduction and fusion by a single posterior approach from June 2009 to January 2018. The modified lumbosacral angle (mLSA) and kyphosis correction index(KCI) were used to evaluate the degree of lumbosacral kyphotic deformity. The quality of life was evaluated by SRS-22 questionnaire in simplified Chinese. Subscales measuring pain, self-image, mental health, function and the total score were calculated before and after surgery. Correlation between the SRS-22 score and the degree of lumbosacral kyphotic deformity was analyzed by Pearson′s coefficients. Results: At the last follow-up, the slip percentage and lumbosacral kyphosis of all patients in this group were corrected at different degrees. Pre- and post-operative slippage rates were respectively (67.8±11.7)% and (24.8±7.9)%. The mLSA was corrected from kyphotic 18.3°±4.9° before surgery to lordotic 9.8°±8.1° at the final follow-up, and the KCI was 0.64±0.17. The four dimensions of the SRS-22 scale and the total score at the final follow-up were higher than those before surgery. The final follow-up mLSA correlated with better self-image(r=0.684) and the lumbosacral KCI was moderately correlated with self-image score(r=0.481). Conclusions: Reduction and correction of lumbosacral kyphosis can improve the health-related quality of life of patients with severe dysplastic lumbar spondylolisthesis, especially the self-image score. In addition to the slippage degree during surgery, attention should also be paid to the correction of rotational deformities.