Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
Department of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Mito, Japan.
BMC Musculoskelet Disord. 2024 Jan 12;25(1):55. doi: 10.1186/s12891-024-07190-x.
Fifth lumbar vertebra (L5) spondylolysis has a lower bone union rate than non-L5 spondylolysis, but the reason for this is unknown. This study aimed to evaluate the differences in patient and lesion characteristics between L5 and non-L5 spondylolysis.
A total of 410 patients with lumbar spondylolysis aged 18 years or younger who were treated conservatively were enrolled. Patients and lesions were divided into L5 and non-L5 (L2-L4) spondylolysis. Factors, including sex, age, presence of spina bifida occulta, stage of the main side lesion, whether the lesion was unilateral or bilateral, presence and stage of the contralateral side lesion and treatment duration, were evaluated at the first visit and compared between the two groups.
A total of 250 patients with 349 lesions were included. The bone union rate of L5 lesions was lower than that of non-L5 lesions (75% vs. 86%, p = 0.015). Patients with L5 spondylolysis were more likely to be male (86% vs. 66%) and younger (14.0 vs. 14.6 years) than patients with non-L5 spondylolysis. Lesions of L5 spondylolysis were more likely to be in a progressive stage (28% vs. 15%), less likely to be in a pre-lysis stage (28% vs. 43%) and more likely to be in a contralateral terminal stage (14% vs. 5.3%, p = 0.013) compared with lesions of non-L5 spondylolysis.
L5 spondylolysis was characterised by a lower bone union rate, more males, younger age, more progressive stage and more contralateral pseudarthrosis than non-L5 spondylolysis.
第五腰椎（L5）峡部裂的骨愈合率低于非 L5 峡部裂，但原因尚不清楚。本研究旨在评估 L5 和非 L5 峡部裂患者和病变特征的差异。
共纳入 410 例年龄在 18 岁以下接受保守治疗的腰椎峡部裂患者。将患者和病变分为 L5 和非 L5（L2-L4）峡部裂。在初次就诊时评估性别、年龄、是否存在隐性脊柱裂、主侧病变分期、病变是否单侧或双侧、对侧病变存在和分期以及治疗持续时间等因素，并比较两组之间的差异。
共纳入 250 例患者的 349 处病变。L5 病变的骨愈合率低于非 L5 病变（75%比 86%，p=0.015）。L5 峡部裂患者更可能为男性（86%比 66%）和更年轻（14.0 岁比 14.6 岁）。与非 L5 峡部裂相比，L5 峡部裂的病变更可能处于进展期（28%比 15%），不太可能处于前期（28%比 43%），更可能处于对侧终末期（14%比 5.3%，p=0.013）。
与非 L5 峡部裂相比，L5 峡部裂的特征是骨愈合率较低、男性更多、年龄更小、病变更处于进展期且对侧假关节更多。
