{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:26:13Z","timestamp":1788985573379,"version":"build-2803163510"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>This study aimed to examine the vertebral body shape characteristics and spondylopelvic alignment in L4 degenerative spondylolisthesis (DS) as well as the risk factors for the development of DS.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This cross-sectional study compared vertebral morphology and sagittal spinopelvic alignment in female patients with lumbar DS and lumbar spinal stenosis (LSS). The degree of lumbar lordosis (LL), pelvic incidence (PI), cross-sectional area (CSA), and vertebral body height ratio (<jats:italic>h<\/jats:italic><jats:sub><jats:italic>a<\/jats:italic><\/jats:sub><jats:italic>\/h<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub>) of the lumbar spine were compared using full-length spine radiographs and computed tomography in 60 females with DS and in 60 women with LSS.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>No significant differences in age or body mass index were observed between the two groups; however, the DS and LSS groups significantly differed in PI (mean, 58.9\u00b110.8 vs. 47.2\u00b111.6, <jats:italic>P &lt;<\/jats:italic> 0.001), L4 CSA (mean, 1,166.2 m<jats:sup>2<\/jats:sup> vs. 1,242.0 m<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic> = 0.002) and <jats:italic>h<\/jats:italic><jats:sub><jats:italic>a<\/jats:italic><\/jats:sub><jats:italic>\/h<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub> (mean, 1.134 vs. 1.007, <jats:italic>P<\/jats:italic> &lt; 0.001). The L4 <jats:italic>h<\/jats:italic><jats:sub><jats:italic>a<\/jats:italic><\/jats:sub><jats:italic>\/h<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub> was significantly higher in the DS group than in the LSS group. Additionally, LL values were negatively correlated with vertebral L5 CSA in the DS group (r = \u22120.28, <jats:italic>P<\/jats:italic> &lt; 0.05). The LSS and DS groups demonstrated positive correlations between LL and L2, L3, and L4 <jats:italic>h<\/jats:italic><jats:sub><jats:italic>a<\/jats:italic><\/jats:sub><jats:italic>\/h<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub> (r = 0.331, 0.267, and 0.317; <jats:italic>P<\/jats:italic> &lt; 0.01, &lt; 0.05, and &lt; 0.05, respectively) and between LL and L4 and L5 <jats:italic>h<\/jats:italic><jats:sub><jats:italic>a<\/jats:italic><\/jats:sub><jats:italic>\/h<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub> (r = 0.333, 0.331; <jats:italic>P<\/jats:italic> &lt; 0.01, respectively). Multivariate regression analyses revealed that PI and <jats:italic>h<\/jats:italic><jats:sub><jats:italic>a<\/jats:italic><\/jats:sub><jats:italic>\/h<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub> ratio may be independent predictors of DS development.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The DS group had significantly larger LL, PI, and L4 <jats:italic>h<\/jats:italic><jats:sub><jats:italic>a<\/jats:italic><\/jats:sub><jats:italic>\/h<\/jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub> and smaller L4 CSA than the LSS group. The lumbar vertebral body shape and sagittal spinopelvic alignment in females might be independent predictors of DS development.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0301974","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T18:16:40Z","timestamp":1713291400000},"page":"e0301974","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Analyzing lumbar vertebral shape and alignment in female patients with degenerative spondylolisthesis: Comparisons with spinal stenosis and risk factor exploration"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9918-203X","authenticated-orcid":true,"given":"Tomohito","family":"Yoshihara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3359-9684","authenticated-orcid":true,"given":"Tadatsugu","family":"Morimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatsugu","family":"Tsukamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Toda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaomi","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Takashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Mawatari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"pone.0301974.ref001","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1210\/er.2017-00147","article-title":"Sexual dimorphism and the origins of human spinal health","volume":"39","author":"V Gilsanz","year":"2018","journal-title":"Endocr Rev"},{"key":"pone.0301974.ref002","doi-asserted-by":"crossref","first-page":"e0172844","DOI":"10.1371\/journal.pone.0172844","article-title":"Association between vertebral cross-sectional area and lumbar lordosis angle in adolescents.","volume":"12","author":"TA Wren","year":"2017","journal-title":"PLoS One"},{"key":"pone.0301974.ref003","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1097\/01.BRS.0000132312.78469.7B","article-title":"Sagittal alignment of the spine and pelvis during growth.","volume":"29","author":"J-M Mac-Thiong","year":"2004","journal-title":"Spine"},{"key":"pone.0301974.ref004","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1007\/s00247-016-3633-8","article-title":"Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis.","volume":"46","author":"S Ponrartana","year":"2016","journal-title":"Pediatr Radiol"},{"key":"pone.0301974.ref005","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1002\/jbmr.3210","article-title":"Association between vertebral cross-sectional area and vertebral wedging in children and adolescents: a cross-sectional analysis","volume":"32","author":"TA Wren","year":"2017","journal-title":"J Bone Miner Res"},{"key":"pone.0301974.ref006","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1097\/BRS.0000000000002480","article-title":"Increased lumbar lordosis and smaller vertebral cross-sectional area are associated with spondylolysis.","volume":"43","author":"TAL Wren","year":"2018","journal-title":"Spine"},{"key":"pone.0301974.ref007","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1038\/nature03052","article-title":"Endurance running and the evolution of Homo","volume":"432","author":"DM Bramble","year":"2004","journal-title":"Nature"},{"key":"pone.0301974.ref008","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1148\/rg.342135070","article-title":"MR imaging of normal epiphyseal development and common epiphyseal disorders","volume":"34","author":"C Jaimes","year":"2014","journal-title":"Radiographics"},{"key":"pone.0301974.ref009","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jspd.2017.01.007","article-title":"Biomechanical modeling of Sspine flexibility and its relationship to spinal range of motion and idiopathic scoliosis.","volume":"5","author":"TAL Wren","year":"2017","journal-title":"Spine Deform"},{"key":"pone.0301974.ref010","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s13018-015-0262-0","article-title":"A new sagittal parameter to estimate pelvic tilt using the iliac cortical density line and iliac tilt: a retrospective X-ray measurement study.","volume":"10","author":"T Doi","year":"2015","journal-title":"J Orthop Surg Res"},{"key":"pone.0301974.ref011","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1097\/00007632-199011010-00021","article-title":"Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage","volume":"15","author":"S Matsunaga","year":"1990","journal-title":"Spine"},{"key":"pone.0301974.ref012","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s13018-018-0723-3","article-title":"Double-level lumbar spondylolysis and spondylolisthesis: a retrospective study.","volume":"13","author":"S Zhang","year":"2018","journal-title":"J Orthop Surg Res"},{"key":"pone.0301974.ref013","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s00586-009-0941-9","article-title":"Treatment of degenerative spondylolisthesis: potential impact of dynamic stabilization based on imaging analysis.","volume":"18","author":"TW Lawhorne","year":"2009","journal-title":"Eur Spine J."},{"key":"pone.0301974.ref014","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1007\/s00223-014-9868-1","article-title":"The ratio of anterior and posterior vertebral heights reinforces the utility of DXA in assessment of vertebrae strength","volume":"95","author":"G Taton","year":"2014","journal-title":"Calcif Tissue Int"},{"key":"pone.0301974.ref015","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1007\/s00586-006-0294-6","article-title":"Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases.","volume":"16","author":"C Barrey","year":"2007","journal-title":"Eur Spine J"},{"key":"pone.0301974.ref016","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1302\/0301-620X.77B1.7822369","article-title":"Oophorectomy predisposes to degenerative spondylolishtesis","volume":"77","author":"K Imada","year":"1995","journal-title":"J Bone Joint Surg"},{"key":"pone.0301974.ref017","doi-asserted-by":"crossref","first-page":"e0190225","DOI":"10.1371\/journal.pone.0190225","article-title":"Vertebral cross-sectional growth: a predictor of vertebral wedging in the immature skeleton.","volume":"12","author":"E Poorghasamians","year":"2017","journal-title":"PLoS One"},{"key":"pone.0301974.ref018","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1002\/jbmr.1658","article-title":"The effect of thoracic kyphosis and sagittal plane alignment on vertebral compressive loading","volume":"27","author":"AG Bruno","year":"2012","journal-title":"J Bone Miner Res"},{"key":"pone.0301974.ref019","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1007\/s00198-007-0356-6","article-title":"Vertebral dimensions as risk factor of vertebral fracture in osteoporotic patients: a systematic literature review.","volume":"18","author":"A Ruyssen-Witrand","year":"2007","journal-title":"Osteoporos Int"},{"key":"pone.0301974.ref020","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1302\/0301-620X.58B2.932080","article-title":"Degenerative spondylolisthesis.","volume":"58","author":"JAW Fitzgerald","year":"1976","journal-title":"J Bone Joint Surg"},{"key":"pone.0301974.ref021","doi-asserted-by":"crossref","first-page":"3408","DOI":"10.1210\/JC.2015-2176","article-title":"Incident vertebral fractures in children with leukemia during the four years following diagnosis","volume":"100","author":"EA Cummings","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"pone.0301974.ref022","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s00198-013-2520-5","article-title":"Bone complications in patients with Cushing\u2019s syndrome: looking for clinical, biochemical, and genetic determinants.","volume":"25","author":"L Trementino","year":"2014","journal-title":"Osteoporos Int."},{"key":"pone.0301974.ref023","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1007\/s11914-014-0222-3","article-title":"Bone morbidity in childhood leukemia: epidemiology, mechanisms, diagnosis, and treatment","volume":"12","author":"S Mostoufi-Moab","year":"2014","journal-title":"Curr Osteoporos Rep"},{"key":"pone.0301974.ref024","doi-asserted-by":"crossref","first-page":"2760","DOI":"10.1200\/JCO.2011.40.4830","article-title":"High incidence of vertebral fractures in children with acute lymphoblastic leukemia 12 months after the initiation of therapy.","volume":"30","author":"N Alos","year":"2012","journal-title":"J Clin Oncol."},{"key":"pone.0301974.ref025","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1359\/jbmr.090202","article-title":"Advanced vertebral fracture among newly diagnosed children with acute lymphoblastic leukemia: results of the Canadian Steroid-Associated Osteoporosis in the Pediatric Population (STOPP) research program.","volume":"24","author":"J Halton","year":"2009","journal-title":"J Bone Miner Res"},{"key":"pone.0301974.ref026","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1210\/jc.2005-0582","article-title":"Bone demineralization and vertebral fractures in endogenous cortisol excess: role of disease etiology and gonadal status","volume":"91","author":"L Tauchmanova","year":"2006","journal-title":"J Clin Endocrinol Metab"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0301974","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T18:16:53Z","timestamp":1713291413000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0301974"}},"subtitle":[],"editor":[{"given":"Holakoo","family":"Mohsenifar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0301974","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,16]]}}}