Specific pattern of ruptured annulus fibrosus in lumbar degenerative spondylolisthesis.

In order to study the antepriori etiologic factors of degenerative spondylolisthesis, the discograms and CTD were analyzed and the rate of disc slipping and disc indices wer evaluated in 30 cases with degenerative spondylolisthesis. (1) The characteristic S-shaped image which extended from anteroinferior to posterosuperior up to the posterior margin of a vertebral body was observed in 89.7% of slipped discs in lateral discograms. CTD revealed that this image represented a circular splitting in the external and intermediate annulus fibrosus. (2) Discographic degeneration of the discs adjacent to a slipped disc was relatively mild, and their disc indices were not significantly different from those of controls. (3) A negative correlation with r = -0.434 was found between the slipping rate and the disc index. From these results, it was postulated that the site and direction of the circular splitting in laminae of the annulus fibrosus, and the direction of the load applied to an intervertebral disc are important etiologic factors of degenerative spondylolisthesis.