Lumbar Spondylolysis in the Pediatric Population: A Retrospective CT Review With Radiology Rereview.
作者信息
Rambo Anna J, Sheffer Benjamin W, Hajek Blake, Almatari Abraham, Suit Parker, Rhodes Leslie N, Cao Xueyuan, Warner William C, Sawyer Jeffrey R, Kelly Derek M, Spence David D
机构信息
From the Department of Orthopedics and Sports Medicine, Nemours Children's Health, Jacksonville, FL (Rambo), the Department of Health Promotion and Disease Prevention, University of Tennessee Health Science Center, Memphis, TN (Hajek, Almatari, Rhodes, and Cao), the Le Bonheur Children's Hospital, Memphis, TN (Rhodes), the Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, Memphis, TN (Sheffer, Warner, Sawyer, Kelly, and Spence), and the Baptist Memorial Hospital, Radiology Residency Program, Memphis, TN (Suit).
出版信息
J Am Acad Orthop Surg. 2025 Jun 1;33(11):579-584. doi: 10.5435/JAAOS-D-23-00543. Epub 2025 Apr 10.
INTRODUCTION
Spondylolysis, a defect in the pars interarticularis, can be symptomatic or asymptomatic with an estimated prevalence of 4% by age 6 years and 6% by adulthood. This study's goal was to determine the prevalence of lumbar spondylolysis found on CT scans in children and to characterize patient-specific risk factors.
METHODS
Abdominopelvic CT scans done (2017 to 2020) in patients up to age 18 years were reviewed. The radiology report was retrospectively reviewed for a spondylolysis, and a radiologist rereviewed the CT scan. Patient demographics and indications for CT scan were included. Firth bias-reduced logistic regression was used to model spondylolysis with each demographic variable as a predictor.
RESULTS
One thousand nine hundred thirty-one CT reports and imaging were reviewed; abdominal pain (41.91%) and trauma (29.46%) were the most common reasons for CT scan. Spondylolysis was found in 42 patients (2.18%) per the radiology report and in 71 patients (3.68%) on radiologist overread. Median age was 13 years (interquartile range, 10 to 16 years). Age groups had the following prevalence: 0 to 6 years (0.41%); 7 to 10 years (1.58%); 11 to 13 years (3.59%); 14 to 18 years (5.1%). Increased prevalence was found in ages 14 to 18 years that was statistically significant (odds ratio 1; P = 0.0004). L5 was the most common level; most defects were bilateral. White patients had a higher rate of spondylolysis (5.06%) than Black patients (2.05%). Black patients were less likely to have a spondylolysis with an OR of 0.4 (0.22 to 0.69; P = 0.0007).
DISCUSSION
This study demonstrated a lower prevalence of lumbar spondylolysis (3.68%) in children compared with the previous literature. Increasing prevalence with age suggests that spondylolysis develops over time, likely because of repetitive stress. Future studies should characterize these age-related and race-related differences for better understanding.
LEVEL OF EVIDENCE
Level IV, retrospective.
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