Profiles of the cervical, thoracic, and lumbosacral spine in children and adolescents with lumbosacral spondylolisthesis

The sagittal and frontal profiles of the entire spine are poorly studied in lumbosacral spondylolisthesis. It was the purpose of this study to further investigate these profiles. Standing posterior-anterior and lateral radiog raphs in 24 children with lumbosacral spondylolisthesis were reviewed (18 i sthmic, 6 congenital). Cervical lordosis, lumbar lordosis, thoracic kyphosi s, sagittal vertebral axis, sacral inclination, slip magnitude, slip angle, and sagittal rotation were measured. Cobb magnitude, Risser sign, curve lo cation, and direction were noted for those with scoliosis. Relationships be tween sagittal variables were explored (Pearson correlation). The average a ge of patients was 14.7 +/- 2.5 years, slip magnitude was 38 +/- 38%, slip angle was 5 +/- 31 degrees, sagittal rotation was -6 +/- 31 degrees, thorac ic kyphosis was 29 +/- 16 degrees, cervical lordosis was -1 +/- 12 degrees, and lumbar lordosis was 62 +/- 22 degrees. Correlations were noted between thoracic kyphosis and sacral inclination, percent slip, slip angle, and sa gittal rotation. Sacral inclination decreased as the slip increased. Scolio sis was present in 10 children, with an average curve of 19 +/- 6 degrees. Thoracic kyphosis was less in those with scoliosis (21 +/- 25 degrees versu s 33 +/- 25 degrees, p = 0.033). In children with lumbosacral spondylolisth esis, the sacrum becomes more vertical as the slip worsens. As the sacrum b ecomes more vertical, the thoracic spine becomes more lordotic, which is li kely an adaptive mechanism used by the body to maintain for-ward visual gaz e.