Lemoine Thibaut, Fournier Joseph, Odent Thierry, Sembély-Taveau Catherine, Merenda Pauline, Sirinelli Dominique, Morel Baptiste
Department of Pediatric Radiology, Clocheville Hospital, CHRU Tours, 49 Boulevard Beranger, 37000, Tours, France.
Department of Spinal Surgery, The Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, England, UK.
Eur Spine J. 2018 May;27(5):1067-1072. doi: 10.1007/s00586-017-5339-5. Epub 2017 Oct 13.
Although lumbar spondylolysis is encountered in general population with an incidence estimated to be 3-10%, limited information is available for children. The aim of the study is to determine the prevalence of spondylolysis according to associated vertebral bony malformation and spinopelvic parameters in children under eight requiring CT evaluation for unrelated lumbar conditions.
Seven hundred and seventeen abdominal and pelvic multi-detector CT scans were obtained in patients under 8 years of age were reviewed. Two board certificated radiologists and two resident radiologists retrospectively evaluated CT scans for lumbar spondylolysis and associated malformations. Pelvic incidence and spondylolisthesis were reported.
Our analysis included 717 CT scans in 532 children (259 girls and 273 boys). Twenty-five cases of spondylolysis were diagnosed (16 bilateral and 9 unilateral, 64 and 36%, respectively) in 14 boys (56%) and 11 girls (44%), associating with 12 grade I spondylolisthesis. The mean normal pelvic incidence was 45° (median 44°, SD 7°). The prevalence of spondylolysis was 1% in children under age 3 (n = 3 among 292 patients), 3.7% in children under age 6 (n = 17 among 454 patients) and 4.7% among the 532 patients. Unilateral spondylolysis was significantly associated with a spinal malformation (p = 0.04, Fisher's exact test), with normal pelvic incidence. Half of the patients with bilateral spondylolysis had high pelvic incidence.
We observed a prevalence peak of unilateral spondylolysis in the context of a specific malformation in young infants under age 4 with normal pelvic incidence, and, then, a progressive increase in the prevalence of bilateral isolated spondylolysis.
虽然腰椎峡部裂在普通人群中的发病率估计为3%-10%，但关于儿童腰椎峡部裂的信息有限。本研究的目的是确定因无关腰椎疾病而需要进行CT评估的8岁以下儿童中，根据相关椎体骨畸形和脊柱骨盆参数得出的腰椎峡部裂患病率。
回顾了对8岁以下患者进行的717例腹部和盆腔多排CT扫描。两名获得委员会认证的放射科医生和两名住院放射科医生对腰椎峡部裂及相关畸形的CT扫描进行了回顾性评估。报告了骨盆倾斜角和腰椎滑脱情况。
我们的分析包括532名儿童（259名女孩和273名男孩）的717例CT扫描。诊断出25例腰椎峡部裂（16例双侧和9例单侧，分别占64%和36%），其中14名男孩（56%）和11名女孩（44%），伴有12例I度腰椎滑脱。正常骨盆倾斜角的平均值为45°（中位数44°，标准差7°）。3岁以下儿童的腰椎峡部裂患病率为1%（292例患者中有3例），6岁以下儿童为3.7%（454例患者中有17例），532例患者中为4.7%。单侧腰椎峡部裂与脊柱畸形显著相关（p = 0.04，Fisher精确检验），骨盆倾斜角正常。双侧腰椎峡部裂患者中有一半骨盆倾斜角较高。
我们观察到，在4岁以下骨盆倾斜角正常的幼儿中，单侧腰椎峡部裂在特定畸形情况下患病率达到峰值，然后双侧孤立性腰椎峡部裂的患病率逐渐增加。
