Lumbosacral anatomy is unique in pediatric spondylolysis.

IF 1.8 Q3 CLINICAL NEUROLOGY Spine deformity Pub Date : 2025-07-01 Epub Date: 2025-04-03 DOI:10.1007/s43390-025-01084-1

Ryan A Finkel, Nakul Narendran, Daniel Farivar, Paal Nilssen, Melodie F Metzger, David L Skaggs, Kenneth D Illingworth

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Abstract

Purpose: To determine whether patients with L5 spondylolysis have different lumbosacral anatomy compared to patients without L5 spondylolysis.

Methods: Computed tomography (CT) scans of pediatric patients with isolated L5 spondylolysis were identified and matched 1:4 (age, sex, BMI) to patients without spondylolysis. Sagittal parameters assessed included sacral slope angle, sacral table angle, L4-S1 and L5-S1 Cobb angles, the horizontal angle of the L5 pars interarticularis, the distances between the L4 inferior articular process (IAP) and the S1 superior articular process (SAP) and their respective individual distances to the L5 pars. Coronal parameters assessed included the percent subluxation of L4 IAP below the facet joint.

Results: 1084 CT scans were reviewed. 32 patients with isolated L5 spondylolysis were identified and matched to 122 patients without spondylolysis. The horizontal angle of the L5 pars was greater in spondylolysis patients (142.5 ± 10.2 vs. 119.9 ± 5.9, p < 0.05). There was less distance (mm) between L4 IAP and S1 SAP (11.3 ± 3.9 vs. 14.7 ± 2.9, p < 0.05) and less distance (mm) from both L4 IAP (2.6 ± 1.7 vs. 5.4 ± 2.2, p < 0.05) and S1 SAP (0.7 ± 0.4 vs. 1.5 ± 0.7, p < 0.05), respectively, to the L5 pars in the spondylolysis group. Pearson's analyses revealed that a larger horizontal angle of the L5 pars was strongly associated with spondylolysis (0.59).

Conclusion: Pediatric patients with L5 spondylolysis have a significantly more horizontal L5 pars that is closer to both the L4 IAP and S1 SAP.

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腰骶解剖在小儿峡部裂中是独特的。

目的：确定L5峡部裂患者与无L5峡部裂患者的腰骶解剖结构是否不同。方法：对孤立性L5椎体裂的儿童患者进行CT扫描，并将其与非椎体裂患者进行1:4（年龄、性别、BMI）匹配。评估的矢状面参数包括骶斜坡角、骶表角、L4-S1和L5-S1 Cobb角、L5关节间部水平角、L4下关节突（IAP）和S1上关节突（SAP）之间的距离以及它们各自到L5关节间部的距离。评估的冠状面参数包括小关节以下L4 IAP半脱位的百分比。结果：共回顾CT扫描1084张。32例孤立性L5峡部裂患者被确定并与122例无峡部裂患者匹配。结论：儿童L5峡部裂患者L5峡部水平角度更接近L4 IAP和S1 SAP，且水平角度更接近L4 IAP和S1 SAP。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine deformity

CiteScore

3.20

自引率

18.80%

发文量

167

期刊介绍： Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.