Yamane Yuji, Toda Hajime, Katayose Masaki
Department of Physical Therapy, School of Rehabilitation Sciences, Health Sciences University of Hokkaido, Tobetsu, Japan.
Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
Spine Surg Relat Res. 2024 Jun 24;9(1):78-86. doi: 10.22603/ssrr.2024-0057. eCollection 2025 Jan 27.
Fifth lumbar (L5) vertebral morphology contributes to spondylolysis. However, there are no comprehensive examinations of the three-dimensional vertebral shape in early-stage cases. This study aimed to investigate the overall L5 vertebral shape in early-stage spondylolysis.
Homologous models of the L5 vertebra were constructed using computed tomography data from 72 patients with early-stage spondylolysis (SP group) and 95 patients without spondylolysis (CON group). Principal component analysis was performed on the three-dimensional coordinates of all vertices of the generated homologous models. The groups' principal component scores were compared.
Principal component (PC) 3, which represents the morphology of the cross-sectional area of the vertebral body; length of pedicle, neural arch, and isthmus; shape of the vertebral body; and spinous process orientation were significantly higher in the SP group than in the CON group. Additionally, the SP group showed higher values for PC10, which represents the morphology of the anteroposterior length of the vertebral body and transverse process orientation. Compared to the CON group, the SP group's PC3 had a smaller cross-sectional vertebral body area, longer pedicle and neural arch length, larger dorsal wedge shape of the vertebral body, horizontally oriented spinous process, and a shorter isthmus length. PC10, compared with the CON group, indicated the SP group had a shorter anteroposterior length of the superior and inferior surfaces of the vertebral body and a coronally oriented transverse process.
The overall L5 vertebral shape differed between individuals with and without early-stage spondylolysis. Our findings suggest that a wedge-shaped vertebral body and shorter isthmus length may be associated with spondylolysis development. Our study may be valuable in elucidating spondylolysis pathogenesis and may contribute to early detection and prevention.
第五腰椎（L5）椎体形态与椎弓根峡部裂有关。然而，目前尚无对早期病例三维椎体形状的全面研究。本研究旨在探讨早期椎弓根峡部裂患者L5椎体的整体形状。
利用72例早期椎弓根峡部裂患者（SP组）和95例无椎弓根峡部裂患者（CON组）的计算机断层扫描数据构建L5椎体的同源模型。对生成的同源模型所有顶点的三维坐标进行主成分分析。比较两组的主成分得分。
代表椎体横截面积形态、椎弓根长度、神经弓长度、峡部长度、椎体形状和棘突方向的主成分（PC）3在SP组显著高于CON组。此外，SP组的PC10值也较高，PC10代表椎体前后长度和横突方向的形态。与CON组相比，SP组的PC3显示椎体横截面积较小、椎弓根和神经弓长度较长、椎体背侧楔形较大、棘突水平方向以及峡部长度较短。与CON组相比，PC10表明SP组椎体上下表面的前后长度较短且横突呈冠状方向。
有和没有早期椎弓根峡部裂的个体之间L5椎体的整体形状不同。我们的研究结果表明，椎体楔形和峡部长度较短可能与椎弓根峡部裂的发生有关。我们的研究可能对阐明椎弓根峡部裂的发病机制有价值，并可能有助于早期检测和预防。
