PAC System for Radiographic Comparison of Standing and Supine Lateral Views in Patients with Low-Grade Spondylolisthesis


  • Aatir Javaid
  • Sibtain Raza
  • Usman Amjad
  • Shaharyar Sheikh
  • Izza Nasir
  • Saman Shahid



picture archiving and communication system, digital imaging and communication in medicine, low-grade spondylolisthesis


Objective:  Supine views may not adequately depict low-degree spondylolisthesis, thereby confusing surgeons in deciding the best therapy plan. The study aimed to compare the standing vs. supine radiographs for the radiological parameters.

Materials and Methods:  A retrospective investigation was conducted on the standing and supine lateral radiographs of 73 patients with graduation I and II spondylolisthesis at the orthopedic Outdoor patient department. The measurements included lumbar lordosis angle, sacral inclination, slip angle, disc slip, and disc height, which were obtained from the PACS. 

Results:  Mean age was 47.28 years with 41% male and 58.9% females. Prevalence showed 46.57% having L4, 5 level involvement and 53.4% having L5, S1 level involvement in spondylolisthesis. The degree of lumbar lordosis turned out to be 41.7 upon standing while it was 34.39 degrees upon supine position. The size of the disc slip was 0.85cm and 0.74 cm in standing and supine positions respectively. Standing sacral inclination was 45.5 degrees and 40.51 degrees in supine. The slip angle was higher in standing (4.5 degrees) versus 3.97 degrees in the supine position. Disc heights were nearly the same in standing or supine (1.2 cm vs. 1.1 cm) positions. There existed a significant difference between standing vs. supine positions for the following: lumbar lordosis, disc slip, sacral inclination, and slip angle.

Conclusion:  Supine views may not accurately show important radiological findings, affecting the choice of treatment. Surgeons may use these findings to make informed decisions about the best treatment plan.


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