Department of Diagnostic Orthopedics, Tokushima University Graduate School, Institute of Health Sciences, 3-18-15 Kuramoto, Tokushima, 770-8501, Japan.
Department of Orthopedics, Shikoku Medical Center for Children and Adults, 2-1-1 Senyu-cho, Zentsuji-shi, Kagawa, 765-8507, Japan.
Eur Spine J. 2022 Apr;31(4):858-864. doi: 10.1007/s00586-022-07139-5. Epub 2022 Mar 2.
To investigate the association of spinal anomalies with lumbar spondylolysis and spina bifida occulta (SBO).
A total of 1190 patients with thoracic, abdominal, and pelvic computed tomography scans available were categorized according to the number of presacral (thoracic and lumbar) mobile vertebrae and the presence or absence of lumbosacral transitional vertebrae (LSTV). The prevalence of spondylolysis and SBO and the association of spinal anomalies with these disorders were evaluated.
Normal morphology (17 mobile vertebra with no LSTV) was found in 607 men (86.5%) and 419 women (85.9%) and about 14% of patients had anomalies. Spondylolysis was found in 74 patients (6.2%), comprising 54 men (7.7%) and 20 women (4.1%). SBO involving the lumbar spine was found in 9 men (1.3%) and 2 women (0.4%). Spondylolysis was significantly more common in men with 18 vertebrae without LSTV (21.1%) than in those with 17 vertebrae without LSTV (7.2%) (p = 0.002). The prevalence of spinal anomalies was 55.6% in men and 50.0% in women with SBO that included a lumbar level was significantly higher than in both men (13.5%, p < 0.001) and women (4.8%, p = 0.003) without SBO.
These findings indicate that there is a relationship between spinal anomalies and both spondylolysis and SBO, which may lead to elucidation of the mechanism of onset of spondylolysis and improve its treatment and prognosis. Awareness that patients with SBO involving the lumbar spine have an increased likelihood of a spinal anomaly may help to prevent level errors during spinal surgery.
研究脊柱异常与腰椎峡部裂和隐性脊柱裂（SBO）的关系。
根据术前骶骨（胸腰椎）活动椎骨的数量和是否存在腰骶移行椎（LSTV），对 1190 例接受胸、腹、骨盆 CT 扫描的患者进行分类。评估脊柱裂和 SBO 的发生率以及脊柱异常与这些疾病的关系。
17 个活动椎骨且无 LSTV 的正常形态在 607 名男性（86.5%）和 419 名女性（85.9%）中发现，约 14%的患者存在异常。发现 74 例（6.2%）患者有峡部裂，包括 54 名男性（7.7%）和 20 名女性（4.1%）。发现 9 名男性（1.3%）和 2 名女性（0.4%）存在 SBO 累及腰椎。18 个无 LSTV 的椎骨且无 LSTV 的男性峡部裂明显比 17 个无 LSTV 的椎骨且无 LSTV 的男性更常见（21.1%比 7.2%）（p=0.002）。在 SBO 中，包括腰椎水平的男性脊柱异常发生率为 55.6%，女性为 50.0%，明显高于男性（13.5%，p<0.001）和女性（4.8%，p=0.003）无 SBO 的患者。
这些发现表明，脊柱异常与峡部裂和 SBO 之间存在关系，这可能有助于阐明峡部裂的发病机制，并改善其治疗和预后。认识到 SBO 累及腰椎的患者发生脊柱异常的可能性增加，可能有助于防止脊柱手术中的水平错误。
