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Twenty-nine adolescent patients with <jats:bold>symptomatic<\/jats:bold> lumbar isthmic spondylolisthesis were included. For each patient, two age-matched, gender-matched and BMI-matched controls were enrolled. Comparison analyses detected higher values in the case group for the following parameters: CL (\u221222.06\u2009\u00b1\u20097.552\u00b0 versus \u221220.36\u2009\u00b1\u20097.016\u00b0, P\u2009&lt;\u20090.001), T1 Slope (19.84\u2009\u00b1\u20098.708\u00b0 versus 13.99\u2009\u00b1\u20096.537\u00b0, P\u2009=\u20090.001), PT (21.54\u2009\u00b1\u20099.082\u00b0 versus 8.87\u2009\u00b1\u20097.863\u00b0, P\u2009&lt;\u20090.001), PI (64.45\u2009\u00b1\u200913.957\u00b0 versus 43.60\u2009\u00b1\u20099.669\u00b0, P\u2009&lt;\u20090.001), SS (42.90\u2009\u00b1\u20099.183\u00b0 versus 34.73\u2009\u00b1\u20098.265\u00b0, P\u2009&lt;\u20090.001), LL (\u221250.82\u2009\u00b1\u200921.596\u00b0 versus \u221243.78\u2009\u00b1\u200910.356\u00b0, P\u2009=\u20090.042), SVA (16.99\u2009\u00b1\u200914.625\u2009mm versus 0.32\u2009\u00b1\u200931.824\u2009mm, P\u2009=\u20090.009), L5 Slope (33.95\u2009\u00b1\u200913.567\u00b0 versus 19.03\u2009\u00b1\u20096.809\u00b0, P\u2009&lt;\u20090.001), and L5I (8.90\u2009\u00b1\u20096.556\u00b0 versus 1.29\u2009\u00b1\u20096.726\u00b0, P\u2009&lt;\u20090.001). Conversely, TS-CL (6.56\u2009\u00b1\u20096.716\u00b0 versus 11.04\u2009\u00b1\u20097.085\u00b0, P\u2009=\u20090.006), cSVA (11.31\u2009\u00b1\u20096.867\u2009mm versus 17.92\u2009\u00b1\u200911.832\u2009mm, P\u2009=\u20090.007), and TLK (\u22122.66\u2009\u00b1\u200910.101\u00b0 versus 2.71\u2009\u00b1\u20097.708\u00b0, P\u2009=\u20090.007) were smaller in the case group. Slippage percentage was most correlated with PI (r\u2009=\u20090.530, P\u2009=\u20090.003), followed by PT (r\u2009=\u20090.465, P\u2009=\u20090.011) and L5I (r\u2009=\u20090.433, P\u2009=\u20090.019). Results of binary logistic regression showed that the main risk factor of isthmic spondylolisthesis was PI (OR\u2009=\u20091.145, 95%CI\u2009=\u20091.083\u20131.210, P\u2009&lt;\u20090.001). Further subgroup analysis also showed that PI was the main risk factor of isthmic spondylolisthesis in the female adolescents (OR\u2009=\u20091.237, 95%CI\u2009=\u20091.086\u20131.493, P\u2009=\u20090.003) and in the male adolescents (OR\u2009=\u20091.523, 95%CI\u2009=\u20091.093\u20132.123, P\u2009=\u20090.013). PI was the main risk factor for adolescent <jats:bold>symptomatic<\/jats:bold> isthmic spondylolisthesis in the Chinese Han adolescents. The greater PI indicated the higher the progressive risk of spondylolisthesis. In these isthmic spondylolisthesis adolescents, the body always inclined forward and lumbar and cervical lordosis increased.<\/jats:p>","DOI":"10.1038\/s41598-018-29260-6","type":"journal-article","created":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T15:08:26Z","timestamp":1531494506000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Difference of Sagittal Alignment between Adolescents with Symptomatic Lumbar Isthmic Spondylolisthesis and the General Population"],"prefix":"10.1038","volume":"8","author":[{"given":"Jian","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongqiang","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziqiang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2680-0092","authenticated-orcid":false,"given":"Ming","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2018,7,19]]},"reference":[{"key":"29260_CR1","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1302\/0301-620X.96B6.33075","volume":"96-b","author":"F Altaf","year":"2014","unstructured":"Altaf, F., Heran, M. 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