Masharawi Youssef, Dar Gali, Peleg Smadar, Steinberg Nili, Alperovitch-Najenson Dvora, Salame Khalil, Hershkovitz Israel
Spinal Research Laboratory, Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, P.O. Box 39040, 69978 Tel-Aviv, Israel.
Eur Spine J. 2007 Jul;16(7):993-9. doi: 10.1007/s00586-007-0328-8. Epub 2007 Feb 15.
Opinions differ as to the exact mechanism responsible for spondylolysis (SP) and whether individuals with specific morphological characteristics of the lumbar vertebral neural arch are predisposed to SP. The aim of our study was to reveal the association between SP and the architecture of lumbar articular facets and the inter-facet region.
Using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA, USA), length, width and depth of all articular facets and all inter-facet distances in the lumbar spine (L1-L5) were measured. From the Hamann-Todd Human Osteological Collection (Cleveland Museum of Natural History, OH, USA) 120 normal male skeletons with lumbar spines in the control group and 115 with bilateral SP at L5 were selected. Analysis of variance was employed to examine the differences between spondylolytic and normal spines.
Three profound differences between SP and the norm appeared: (1) in individuals with SP, the size and shape of L4's neural arch had significantly greater inter-facet widths, significantly shorter inter-facet heights and significantly shorter and narrower articular facets; (2) only in the L4 vertebra in individuals with SP was the inferior inter-facet width greater in size than the superior inter-facet width of the vertebra below (L5) (38.7 mm versus 40 mm); (3) in all lumbar vertebrae, the right inferior articular facets in individuals with SP were flatter compared to the control group.
Individuals with L4 "SP" characteristics are at a greater risk of developing fatigue fractures in the form of spondylolysis at L5.
关于导致椎弓崩裂（SP）的确切机制以及腰椎神经弓具有特定形态特征的个体是否易患SP，存在不同观点。我们研究的目的是揭示SP与腰椎关节突及关节突间区域结构之间的关联。
使用三维微scribe仪器（美国加利福尼亚州圣何塞市Immersion公司）测量腰椎（L1 - L5）所有关节突的长度、宽度和深度以及所有关节突间距离。从哈曼 - 托德人类骨学收藏（美国俄亥俄州克利夫兰自然历史博物馆）中，选取120例腰椎正常的男性骨骼作为对照组，以及115例L5双侧发生SP的骨骼。采用方差分析来检验椎弓崩裂脊柱与正常脊柱之间的差异。
SP与正常情况之间出现了三个显著差异：（1）患有SP的个体中，L4神经弓的大小和形状具有显著更宽的关节突间宽度、显著更短的关节突间高度以及显著更短且更窄的关节突；（2）仅在患有SP的个体的L4椎体中，其下关节突间宽度大于下方椎体（L5）的上关节突间宽度（38.7毫米对40毫米）；（3）在所有腰椎中，患有SP的个体的右下方关节突比对照组更扁平。
具有L4“SP”特征的个体发生L5椎弓崩裂形式疲劳骨折的风险更高。
