Finkel Ryan A, Narendran Nakul, Farivar Daniel, Nilssen Paal, Metzger Melodie F, Skaggs David L, Illingworth Kenneth D
Cedars-Sinai Medical Center, Department of Spine Surgery, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA.
Spine Deform. 2025 Jul;13(4):1197-1204. doi: 10.1007/s43390-025-01084-1. Epub 2025 Apr 3.
To determine whether patients with L5 spondylolysis have different lumbosacral anatomy compared to patients without L5 spondylolysis.
Computed tomography (CT) scans of pediatric patients with isolated L5 spondylolysis were identified and matched 1:4 (age, sex, BMI) to patients without spondylolysis. Sagittal parameters assessed included sacral slope angle, sacral table angle, L4-S1 and L5-S1 Cobb angles, the horizontal angle of the L5 pars interarticularis, the distances between the L4 inferior articular process (IAP) and the S1 superior articular process (SAP) and their respective individual distances to the L5 pars. Coronal parameters assessed included the percent subluxation of L4 IAP below the facet joint.
1084 CT scans were reviewed. 32 patients with isolated L5 spondylolysis were identified and matched to 122 patients without spondylolysis. The horizontal angle of the L5 pars was greater in spondylolysis patients (142.5 ± 10.2 vs. 119.9 ± 5.9, p < 0.05). There was less distance (mm) between L4 IAP and S1 SAP (11.3 ± 3.9 vs. 14.7 ± 2.9, p < 0.05) and less distance (mm) from both L4 IAP (2.6 ± 1.7 vs. 5.4 ± 2.2, p < 0.05) and S1 SAP (0.7 ± 0.4 vs. 1.5 ± 0.7, p < 0.05), respectively, to the L5 pars in the spondylolysis group. Pearson's analyses revealed that a larger horizontal angle of the L5 pars was strongly associated with spondylolysis (0.59).
Pediatric patients with L5 spondylolysis have a significantly more horizontal L5 pars that is closer to both the L4 IAP and S1 SAP.
确定与无L5峡部裂的患者相比，L5峡部裂患者的腰骶部解剖结构是否存在差异。
识别出孤立性L5峡部裂儿科患者的计算机断层扫描（CT）图像，并按照1:4的比例（年龄、性别、体重指数）与无峡部裂的患者进行匹配。评估的矢状面参数包括骶骨倾斜角、骶骨平台角、L4-S1和L5-S1 Cobb角、L5关节突间部的水平角、L4下关节突（IAP）与S1上关节突（SAP）之间的距离以及它们各自到L5关节突间部的距离。评估的冠状面参数包括L4 IAP在小关节下方的半脱位百分比。
回顾了1084份CT扫描图像。识别出32例孤立性L5峡部裂患者，并与122例无峡部裂的患者进行匹配。峡部裂患者的L5关节突间部水平角更大（142.5±10.2对119.9±5.9，p<0.05）。L4 IAP与S1 SAP之间的距离（mm）更小（11.3±3.9对14.7±2.9，p<0.05），并且在峡部裂组中，L4 IAP（2.6±1.7对5.4±2.2，p<0.05）和S1 SAP（0.7±0.4对1.5±0.7，p<0.05）到L5关节突间部的距离也更小。Pearson分析显示，L5关节突间部更大的水平角与峡部裂密切相关（0.59）。
患有L5峡部裂的儿科患者的L5关节突间部明显更水平，且更靠近L4 IAP和S1 SAP。
