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• W2894711355 abstract "Study Design: This was a cross-sectional, observational study. Objective: The main objectives of this study were to observe the prevalence of a true L6 among patients with symptomatic adult spinal degeneration, and to evaluate similarities of their radiographic spinopelvic parameters to L5 patients. Summary of Background Data: Spinopelvic parameter values used for diagnosis and surgical planning are different between individuals with 5 or 6 lumbar vertebrae. The difference has not been studied in patients with symptomatic spinal degenerative conditions. Materials and Methods: A total of 775 consecutive symptomatic patients with degenerative spinal disorders were classified as having 5 or 6 lumbar vertebrae in full spine radiographs. Pelvic incidence minus lumbar lordosis (PI-LL), sagittal vertical axis (SVA), pelvic tilt, and T1 pelvic angle were measured in 3 groups: sacral (L5 and L6s) and L6 upper endplate (L6e). Oswestry Disability Index (ODI) was obtained. Results: In total, 715 (92.3%) patients had L5 and 60 (7.7%) had L6. LL values were comparable between the L5 and L6s ( P =0.355) and SVA between all groups ( P =0.869). Only SVA had excellent concordance correlation (ρ c =0.91) between the L6s and L6e groups. PI-LL had significantly different values ( P <0.001 all groups) and distributions between L5 and L6s ( P =0.038), and L6s and L6e ( P <0.001) groups. In patients with severe disability (ODI>40%) the parameters that deteriorate with increasing degeneration (pelvic tilt, T1 pelvic angle, SVA, LL, PI-LL) were not significantly different between L5 and L6s groups unlike patients with ODI<40% while PI remained similarly different ( P <0.001). PI and LL had a multivariate relationship in L6 patients computable as regression model equation: PI (sacrum)=−0.92×LL (L6e)+0.91×LL (sacrum) +1.11×PI (L6e)+10.81 ( R 2 =0.88). Conculsions: L6 variant is fairly common. The radiographic L6 parameters were different from L5 except for SVA and values of patients with severe disability measured from sacrum. PI and LL have a mathematic relationship in L6 patients. The cutoff values for radiographic modifiers need further studies combining radiology and clinical outcome. Level of Evidence: Level III." @default.
• W2894711355 created "2018-10-12" @default.
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• W2894711355 date "2019-02-01" @default.
• W2894711355 modified "2023-09-27" @default.
• W2894711355 title "Spinopelvic Parameters and Sagittal Alignment of Symptomatic Degenerative Adult Spinal Disorder Patients With 6 Lumbar Vertebrae" @default.
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• W2894711355 doi "https://doi.org/10.1097/bsd.0000000000000715" @default.
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