Sugawara Kazuhiro, Iesato Noriyuki, Katayose Masaki
Medical Center, Japan Institute of Sports Sciences, Tokyo, Japan.
Department of Orthopedic Surgery, Sapporo Medical University, Sapporo, Japan.
Asian Spine J. 2018 Dec;12(6):1037-1042. doi: 10.31616/asj.2018.12.6.1037. Epub 2018 Oct 16.
Retrospective study.
This study aimed to investigate whether segmental lumbar hyperlordosis of the affected vertebra in patients with spondylolysis occurs only at L5 or also occurs at L4.
To the best of our knowledge, increase in segmental lordosis of the spondylolytic vertebrae has only been investigated in bilateral L5 spondylolysis; it has not been examined at different levels of bilateral spondylolysis. According to the characteristics of segmental lordosis in bilateral L5 spondylolysis, patients with bilateral L4 spondylolysis may also have increased segmental lordosis of the L4 vertebra.
Patients with bilateral spondylolysis of the L5 or L4 vertebra in 2013-2015 were retrospectively identified from the hospital database. Standing lateral lumbar radiographs were assessed for the angle of segmental lordosis of the L5 and L4 vertebra, sacral slope, and lumbar lordosis. The differences in segmental lordosis of the L5 and L4 vertebra, sacral slope, and lumbar lordosis were determined using non-paired Student t-test.
Overall, 15 cases of bilateral L4 spondylolysis and 41 cases of bilateral L5 spondylolysis satisfied the inclusion and exclusion criteria. Lordosis of the L4 vertebra was significantly greater in the bilateral L4 spondylolysis group (24.2°±7.0°) than that in the L5 spondylolysis group (20.3°±6.1°, p=0.047). Lordosis of the L5 vertebra was significantly lower in the L4 spondylolysis group (27.7°±8.2°) than that in the L5 spondylolysis group (32.5°±7.3°, p=0.040). The sacral slope and lumbar lordosis did not significantly differ between the groups.
Adolescent patients with bilateral spondylolysis have segmental hyperlordosis of the affected vertebra not only at the L5 level but also at the L4 level.
回顾性研究。
本研究旨在调查椎弓根峡部裂患者患椎的节段性腰椎前凸增大是否仅发生在L5，还是也发生在L4。
据我们所知，仅对双侧L5椎弓根峡部裂患者椎弓根峡部裂椎体的节段性前凸增加进行了研究；尚未在双侧椎弓根峡部裂的不同节段进行检查。根据双侧L5椎弓根峡部裂节段性前凸的特点，双侧L4椎弓根峡部裂患者的L4椎体节段性前凸也可能增加。
从医院数据库中回顾性识别出2013年至2015年双侧L5或L4椎体椎弓根峡部裂的患者。对站立位腰椎侧位X线片进行评估，测量L5和L4椎体的节段性前凸角度、骶骨倾斜度和腰椎前凸。使用非配对学生t检验确定L5和L4椎体的节段性前凸、骶骨倾斜度和腰椎前凸的差异。
总体而言，15例双侧L4椎弓根峡部裂和41例双侧L5椎弓根峡部裂患者符合纳入和排除标准。双侧L4椎弓根峡部裂组L4椎体的前凸（24.2°±7.0°）显著大于L5椎弓根峡部裂组（20.3°±6.1°，p=0.047）。L4椎弓根峡部裂组L5椎体的前凸（27.7°±8.2°）显著低于L5椎弓根峡部裂组（32.5°±7.3°，p=0.040）。两组之间的骶骨倾斜度和腰椎前凸无显著差异。
双侧椎弓根峡部裂的青少年患者不仅在L5水平，而且在L4水平都存在患椎的节段性前凸增大。
