Spinal-pelvic sagittal parameters and plantar pressure characteristics in elderly patients with degenerative lumbar spondylolisthesis

• Elderly patients with degenerative lumbar spondylolisthesis exhibit significant increases in pelvic incidence, pelvic tilt, sacral slope, and lumbar lordosis, indicating spinopelvic sagittal imbalance with compensatory pelvic retroversion and lumbar hyperlordosis. • Plantar pressure distribution shifts anteriorly, with increased forefoot pressure and decreased rearfoot pressure, along with specific regional changes (increased left first metatarsal peak pressure, decreased right fifth metatarsal and left arch peak pressures), suggesting foot mechanical asymmetry and instability. • Center of pressure trajectory parameters (length, 95% confidence ellipse area, and average X/Y axis movement) are significantly increased under both eyes-open and eyes-closed conditions, indicating impaired postural control and increased visual dependence. • The study provides biomechanical evidence for the link between spinopelvic sagittal imbalance and plantar pressure changes, supporting the inclusion of plantar pressure analysis in early screening and rehabilitation assessment for degenerative lumbar spondylolisthesis.