The Spinal Research Laboratory, Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, 69978, Tel Aviv, Ramat Aviv, Israel.
Israel Spine Center, Assuta Hospital, Tel-Aviv, Israel.
BMC Musculoskelet Disord. 2021 Dec 8;22(1):1026. doi: 10.1186/s12891-021-04901-6.
Although Degenerative Spondylolisthesis (DS) is a common osseous dysfunction, very few studies have examined the bony morphology of lumbar the neural arch in the population afflicted with DS. Therefore, this study aimed to characterize the neural arch (NA) morphology along the entire lumbar spine in individuals with degenerative spondylolisthesis (DS) and compare them to healthy controls.
One hundred CTs from a database of 500 lumbar CTs of spondylolisthesis were selected. We excluded vertebral fractures, non-L4-L5 slips, previous surgeries, vertebral spondyloarthropathies, and scoliosis. Scans were divided into a study group of 50 individuals with single-level DS (grades 1-2) at L4-5 (25 males and 25 females), and an age-sex matched control group of 50 individuals. Linear and angular measurements from all lumbar segments included: vertebral canals, intervertebral foramens, pedicles, and articular facets.
Compared with the controls, all individuals with DS had greater pedicle dimensions in the lower lumbar segments (∆ = 1 mm-2.14 mm) and shorter intervertebral foramens in all the lumbar segments (∆range:1.85 mm-3.94 mm). In DS females, the lower lumbar facets were mostly wider (∆ = 1.73-2.86 mm) and more sagittally-oriented (∆10°) than the controls. Greater prevalence of grade-3 facet arthrosis was found only in the DS population (DS = 40-90%,controls = 16.7-66.7%). In DS males, degenerated facets were observed along the entire lumbar spine (L1-S1), whereas, in DS females, the facets were observed mainly in the lower lumbar segments (L4-S1). Individuals with DS have shorter intervertebral foramens and greater pedicle dimensions compared with controls.
Females with DS have wider articular facets, more sagittally-oriented facets, and excessively degenerated facets than the controls. This unique NA shape may further clarify DS's pathophysiology and explain its greater prevalence in females compared to males.
尽管退行性腰椎滑脱症（DS）是一种常见的骨骼功能障碍，但很少有研究检查患有 DS 人群的腰椎神经弓的骨骼形态。因此，本研究旨在描述退行性腰椎滑脱症（DS）患者整个腰椎神经弓（NA）的形态，并将其与健康对照组进行比较。
从 500 例腰椎滑脱症的数据库中选择了 100 例 CT。我们排除了椎体骨折、非 L4-L5 滑脱、既往手术、椎体脊椎关节病和脊柱侧凸。扫描分为研究组（50 例单节段 DS 患者，L4-5 级 1-2 级，男女各 25 例）和年龄性别匹配的对照组（50 例）。对所有腰椎节段的线性和角度测量包括：椎管、椎间孔、椎弓根和关节突。
与对照组相比，所有 DS 患者的下腰椎节段的椎弓根尺寸更大（∆=1-2.14mm），所有腰椎节段的椎间孔更短（∆范围：1.85-3.94mm）。在 DS 女性中，下腰椎小关节大多更宽（∆=1.73-2.86mm），矢状面方向更明显（∆10°），与对照组相比。仅在 DS 人群中发现更高级别的 facet 关节炎的患病率更高（DS=40-90%，对照组=16.7-66.7%）。在 DS 男性中，退化的 facet 可见于整个腰椎（L1-S1），而在 DS 女性中，退化的 facet 主要见于下腰椎（L4-S1）。与对照组相比，DS 患者的椎间孔更短，椎弓根尺寸更大。
与对照组相比，DS 女性的关节突更宽，矢状面方向更明显，过度退化的 facet 更多。这种独特的 NA 形状可能进一步阐明 DS 的病理生理学，并解释其在女性中比男性更常见的原因。
