Association between lumbar sacralization and increased degree of vertebral slippage and disc degeneration in patients with L4 spondylolysis
| Autor: | Jian-Ting Chen, Junhao Liu, Zhongyuan Liu, Jingshen Zhuang, Qu Dongbin, Xinqiang Yao, Si-Yuan Zhu, Hui Jiang, Ruoting Ding, Qingan Zhu |
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| Rok vydání: | 2019 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty business.industry General Medicine Spondylolysis Degeneration (medical) Sacrum medicine.disease Spondylolisthesis Surgery 03 medical and health sciences Pseudarthrosis 0302 clinical medicine Lumbar Disc degeneration medicine business 030217 neurology & neurosurgery Lumbosacral joint |
| Zdroj: | Journal of Neurosurgery: Spine. 30:767-771 |
| ISSN: | 1547-5654 |
| DOI: | 10.3171/2018.11.spine18900 |
| Popis: | OBJECTIVEThe aim of this study was to evaluate the effect of lumbar sacralization on the level of vertebral slip and disc degeneration in patients with L4 spondylolysis.METHODSThe authors analyzed data from 102 cases in which patients underwent surgical treatment for L4 spondylolysis and spondylolisthesis at their institution between March 2007 and September 2016. Lumbar sacralization was characterized by the presence of pseudarthrosis and/or bony fusion between the L5 transverse process and sacrum, and the type of lumbosacral transitional vertebra (LSTV) was evaluated with the Castellvi classification. The amount of vertebral slippage was measured using the Taillard technique and Meyerding grade. Degeneration of the L4–5 segment was quantified using the Pfirrmann and Modic classifications. Patients were divided into 2 groups based on the presence or absence of sacralization, and the amount of vertebral slip and degeneration of the L4–5 segment was compared between groups.RESULTSLumbar sacralization was present in 37 (36%) of 102 patients with L4 spondylolysis. The LSTV was type IIa in 10 cases, type IIb in 7, type IIIa in 2, and type IIIb in 18. The levels of vertebral slip and disc degeneration in the group of patients with sacralization were significantly greater than in the group without sacralization. No significant difference was found between the 2 groups with respect to Modic changes.CONCLUSIONSThe increased stability between a sacralized L5 and the sacrum may predispose the L4–5 segment to greater instability and disc degeneration in patients with L4 spondylolysis. |
| Databáze: | OpenAIRE |
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