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

Amandine Sevrain, Carl-Éric Aubin, Hicham Gharbi, Xiaoyu Wang and Hubert Labelle

Article (2012)

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Abstract

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.

Subjects: 1900 Biomedical engineering > 1900 Biomedical engineering
1900 Biomedical engineering > 1903 Biomechanics
9000 Health sciences > 9000 Health sciences
Department: Department of Mechanical Engineering
Funders: CRSNG/NSERC (Industrial Research Chair Program with Medtronic)
PolyPublie URL: https://publications.polymtl.ca/5133/
Journal Title: Scoliosis and Spinal Disorders (vol. 7, no. 1)
Publisher: BioMed Central
DOI: 10.1186/1748-7161-7-2
Official URL: https://doi.org/10.1186/1748-7161-7-2
Date Deposited: 07 Apr 2022 16:21
Last Modified: 01 Oct 2023 07:10
Cite in APA 7: Sevrain, A., Aubin, C.-É., Gharbi, H., Wang, X., & Labelle, H. (2012). Biomechanical evaluation of predictive parameters of progression in adolescent isthmic spondylolisthesis: a computer modeling and simulation study. Scoliosis and Spinal Disorders, 7(1), 2 (9 pages). https://doi.org/10.1186/1748-7161-7-2

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