{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:37:35Z","timestamp":1787755055530,"version":"build-2784847793"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2012,2]]},"abstract":"\n Object<\/jats:title>\n Lumbar degenerative spondylolisthesis (LDS) is common and has generally been characterized as a homogeneous disease entity in the literature and in clinical practice. Because disease variability has not been carefully characterized, stratification of treatment recommendations based on scientific evidence is currently lacking. In this study, the authors analyzed radiographic parameters of patients with LDS at the L4\u20135 level to better characterize this entity.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Demographic data were collected from 304 patients (200 women and 104 men) with LDS at the L4\u20135 level. Plain radiographs including anteroposterior, lateral, and flexion-extension lateral radiographs were analyzed for disc height, segmental angulation, segmental translation, and osteophyte formation. Correlations were sought between the variables of age, sex, disc height, segmental angulation, segmental translation, and osteophyte formation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The mean patient age was 63.8 years (range 40\u201386 years). The mean mid-disc height was 7 mm (range 0\u201314 mm) on the neutral lateral view. The mean angulation between the superior endplate of L-5 and the inferior endplate of L-4 was 6\u00b0 of lordosis (range 13\u00b0 of kyphosis to 23\u00b0 lordosis) on the neutral lateral view. The mean angular change between flexion and extension lateral radiographs was 5\u00b0 (range 0\u00b0\u201317\u00b0). The mean translation on the neutral lateral view was 6 mm (range 0\u201315 mm). The mean change in translational between flexion and extension was 2 mm (range 0\u201311 mm). Twenty patients (7%) exhibited spondylolisthesis only on the flexion view. A significant positive correlation was found between the change in angulation and the change in translation on flexion and extension views (\u03c1 = 0.18, p = 0.001). No significant correlation was found between anterior osteophyte size and mobility with flexion-extension radiographs.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The wide range in all radiographic parameters for LDS confirms the heterogeneous nature of this condition and suggests that a grading system to subclassify LDS may be clinically useful. On flexion and extension radiographs, increased translational motion correlated with increased angular motion. Anterior osteophyte size was not found to be predictive of segmental stability. This data set should prove beneficial to those seeking to subcategorize LDS in the future.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2011.10.spine11140","type":"journal-article","created":{"date-parts":[[2011,11,25]],"date-time":"2011-11-25T09:52:17Z","timestamp":1322214737000},"page":"130-134","source":"Crossref","is-referenced-by-count":26,"title":["A radiographic analysis of degenerative spondylolisthesis at the L4\u20135 level"],"prefix":"10.3171","volume":"16","author":[{"given":"D. Greg","family":"Anderson","sequence":"first","affiliation":[{"name":"1Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Worawat","family":"Limthongkul","sequence":"additional","affiliation":[{"name":"1Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirali","family":"Sayadipour","sequence":"additional","affiliation":[{"name":"1Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Kepler","sequence":"additional","affiliation":[{"name":"1Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Harrop","sequence":"additional","affiliation":[{"name":"2Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Maltenfort","sequence":"additional","affiliation":[{"name":"2Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"1Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Hilibrand","sequence":"additional","affiliation":[{"name":"1Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Rihn","sequence":"additional","affiliation":[{"name":"1Departments of Orthopaedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd J.","family":"Albert","sequence":"additional","affiliation":[{"name":"1Departments of Orthopaedic Surgery 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