Department of Spine and Spinal Cord Surgery, China Rehabilitation Research Center, Beijing, China.
Department of Orthopedic Surgery, Capital Medical University, Beijing, China.
Skeletal Radiol. 2021 Jun;50(6):1125-1130. doi: 10.1007/s00256-020-03658-8. Epub 2020 Oct 28.
To identify a diagnostic indicator of lumbar spondylolysis visible in plain X-ray films.
One hundred and seventy-two patients with low back pain who received X-ray and computerized tomography (CT) examinations were identified and studied. They were divided into three groups: the spondylosis without spondylolisthesis (SWS) group, comprising 67 patients with bilateral pars interarticularis defects at L5 and without spondylolisthesis, the isthmic spondylolisthesis (IS) group, comprising 74 patients with L5/S1 spondylolisthesis and bilateral L5 pars interarticularis defects, and the control group, comprising 31 patients with low back pain but without spondylolysis. The sagittal diameters of the vertebral arch (SDVAs) of L4 and L5 were measured in lateral X-ray image, and the differences in SDVA between L4 and L5 (DSL4-5) in each case were calculated and analyzed.
There were no significant differences in demographic characteristics among the three groups. In the SWS and IS groups, the SDVA of L5 was significantly longer than the SDVA of L4 (p < 0.001), whereas no significant difference found in the control group (p > 0.05). DSL4-5, in which the SDVA of L4 was subtracted from the SDVA of L5, significantly differed among the three groups (p < 0.001), and the normal threshold was provisionally determined to be 1.55 mm.
In bilateral L5 spondylolysis, the SDVA of L5 is wider than the SDVA of L4, and this difference is greater in isthmic spondylolisthesis. This sign in lateral X-rays may provide a simple and convenient aid for the diagnosis of spondylolysis.
确定普通 X 光片可见的腰椎峡部裂的诊断指标。
共纳入 172 例腰痛患者，这些患者均接受了 X 线和计算机断层扫描（CT）检查。将他们分为三组：无峡部裂滑脱（SWS）组，67 例患者双侧 L5 峡部有骨裂但无滑脱；峡部裂型滑脱（IS）组，74 例患者 L5/S1 滑脱且双侧 L5 峡部有骨裂；对照组，31 例腰痛但无峡部裂。在侧位 X 光片上测量 L4 和 L5 的椎弓根矢状径（SDVA），并计算和分析每个病例的 L4 和 L5 之间的 SDVA 差异（DSL4-5）。
三组患者的人口统计学特征无显著差异。在 SWS 和 IS 组中，L5 的 SDVA 明显长于 L4 的 SDVA（p < 0.001），而对照组无明显差异（p > 0.05）。L4 和 L5 的 SDVA 之间的差异（DSL4-5）在三组之间存在显著差异（p < 0.001），并暂定确定正常阈值为 1.55mm。
双侧 L5 峡部裂时，L5 的 SDVA 比 L4 的宽，而在峡部裂型滑脱中这种差异更大。侧位 X 光片上的这种征象可能为峡部裂的诊断提供一种简单、方便的辅助手段。
