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Archives of Orthopaedic and Trauma Surgery

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28-02-2024 | Spondylolisthesis | Orthopaedic Surgery

The clinical and radiographic degenerative spondylolisthesis classification and its predictive value

Authors: Henrik Constantin Bäcker, Peter Turner, Michael A. Johnson, Esther Apos, John Cunningham

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2024

Abstract

Introduction

The clinical and radiographic degenerative spondylolisthesis (CARDS) classification is a new classification that has been introduced for degenerative spondylolisthesis (DS). It has four categories. Our study aimed to analyse the functional and radiographic outcome following DS surgery based on the preoperative CARDS classification.

Methods

A retrospective study of the prospectively collected Australian Spine Registry database was performed. Data on demographics, patient reported outcome measures including the Oswestry Disability Index (ODI) and EQ-5D-3 L scores, and changes in radiographic measurements were analysed. Based on the preoperative findings all x-rays were classified applying the CARDS classification.

Results

Between 2018 and 2021 a total of 54-patients were identified as having had surgery for DS at L4/5. The mean age was 65.3 ± 11.3years and females were predominantly affected (61%). Most cases were of CARDS type C (46%), followed by type B (29%). CARDS type A and D were observed in 18% and 6% respectively. Preoperatively, the L4/5 lordosis was 19.8 ± 6.3° and lumbar lordosis 43.9 ± 12.8°. Postoperatively the L4/5 lordosis alignment changed significantly to 23.5 ± 8.8° (p < 0.05). Preoperatively, the CARDS classification was 34.8 ± 17.4 (type A), 40.5 ± 11.0 (type B), 43.8 ± 12.9 and 50.0 ± 14.4 for type D (Pearson-coefficient 0.284, p = 0.041). Postoperatively this changed to 22.7 ± 16.1, 28.7 ± 21.2, 12.5 ± 13.1, and 6.5 ± 2.1 respectively. Similar improvements were observed for the EQ-5D-3 L.

Conclusion

This study shows that the CARDS classification correlates with preoperative functional scores as well as helping to predict response to surgery. CARDS will likely assist in operative planning and prognostication.

Level of evidence

III, therapeutic and prognostic study.

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Title: The clinical and radiographic degenerative spondylolisthesis classification and its predictive value
Authors: Henrik Constantin Bäcker
Peter Turner
Michael A. Johnson
Esther Apos
John Cunningham
Publication date: 28-02-2024
Publisher: Springer Berlin Heidelberg
Keyword: Spondylolisthesis
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2024
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-024-05261-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The clinical and radiographic degenerative spondylolisthesis classification and its predictive value

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Level of evidence

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