Degenerative spondylolisthesis. Predisposing factors

Rosenberg, Norman J.

doi:10.2106/00004623-197557040-00004

Cited by 253 publications

(174 citation statements)

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“…Third, spinal morphology in individuals with degenerative spondylolisthesis is characterized by high RB-the sum of the lumbar L1-L5 body wedge angles, high lordotic wedging of the L5 vertebral body and similarity in the wedging of the intervertebral disks at spinal levels L2-3 to L5-S1. The small wedging of the intervertebral disc below the slipped vertebra as well as the excessive wedging of the L5 vertebral body in degenerative spondylolisthesis has already been shown by several studies [7][8][9][10][11]22]. There are several limitations of the recent study.…”

Section: Discussionmentioning

confidence: 84%

“…Most studies found a lower lumbar index in spondylolysis patients (more lordotic wedging of the vertebral bodies) [8][9][10]. The wedging of the intervertebral disc below the slipped vertebra has been shown to have diagnostic relevance in individuals with degenerative spondylolisthesis as well as implications to the pathogenesis of disability [7,11].…”

Section: Introductionmentioning

confidence: 99%

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Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study

Been

Hunter

et al. 2010

Eur Spine J

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The objective is to evaluate the geometric parameters of vertebral bodies and intervertebral discs in spinal segments adjacent to spondylolysis and spondylolisthesis. This pilot cross-sectional study was an ancillary project to the Framingham Heart Study. The presence of spondylolysis and spondylolisthesis as well as measurements of spinal geometry were identified on CT imaging of 188 individuals. Spinal geometry measurements included lordosis angle, wedging of each lumbar vertebra and intervertebral disc. Last measurements were used to calculate RB, the sum of the lumbar L1-L5 body wedge angles; and RD, the sum of the lumbar L1-L5 intervertebral disc angles. Using Wilcoxon-Mann-Whitney test we compared the geometric parameters between individuals with no pathology and ones with spondylolysis (with no listhesis) at L5 vertebra, ones with isthmic spondylolisthesis at L5-S1 level, and ones with degenerative spondylolisthesis at L5-S1 level. Spinal geometry in individuals with spondylolysis or listhesis at L5 shows three major patterns: In spondylolysis without listhesis, spinal morphology is similar to that of healthy individuals; In isthmic spondylolisthesis there is high lordosis angle, high L5 vertebral body wedging and very high L4-5 disc wedging; In degenerative spondylolisthesis, spinal morphology shows more lordotic wedging of the L5 vertebral body, and less lordotic wedging of intervertebral discs. In conclusion, there are unique geometrical features of the vertebrae and discs in spondylolysis or listhesis. These findings need to be reproduced in larger scale study.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study

Been

Hunter

et al. 2010

Eur Spine J

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“…The sex ratio of 1 : 2.2 found in this study is slightly lower than that reported by others [21, . Several hormonal and mechanical factors have been reported to contribute to the development of DS [3,9,21,22]. Facet joints and particularly their spatial orientation, however, seem to represent a significant factor.…”

Section: Discussionmentioning

confidence: 99%

Facet joint remodeling in degenerative spondylolisthesis: an investigation of joint orientation and tropism

Berlemann

Jeszenszky

Bühler

et al. 1998

European Spine Journal

103

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IntroductionSeveral studies have attempted to define etiological factors for the development of degenerative spondylolisthesis (DS), and the orientation of lumbar facet angles relative to the transverse plane has been a major focus of interest. The facet joints play a critical role in maintaining stability of the lumbar spine by sharing load in compression and extension, and protecting the disc from excessive shear and rotational forces [1,13,24]. Determined by their spatial orientation, they also guide motion between two adjacent vertebrae. Their oblique orientation in the lumbar spine allows flexion, extension, and lateral bending, but only a small amount of axial rotation [27].It has been shown that in patients with DS, the facet joints are significantly more sagittally oriented, thus allowing the superior vertebra to glide anteriorly. Individuals with sagittally oriented facet joints have therefore been regarded as candidates for DS [23]. However, it is not clear whether this more pronounced sagittal orientation of the facet joint represents a pre-existing morphology or whether it has to be considered a result of secondary remodeling.Facet joint asymmetry (tropism) has been claimed to be related to disc herniation and degenerative disc disease due to rotational instability of the spinal segment [6,8,20]. Whether facet joint tropism plays a role in the development of DS, however, has not been investigated.The present study analyzed facet joint orientation in the transverse plane in patients with DS and compared this to patients with no evidence of ventrolisthesis from three different age groups. The working hypothesis was that if the more sagittal orientation in DS was a pre-existing anatomical feature, it then should be possible to identify a younger patient group being "at risk" for the development of DS later in life. The incidence of facet joint tropism in the different groups was also investigated.Abstract This study analyzed transverse facet joint angulations at the three lower lumbar levels in 132 patients assigned to one of four groups. Group A comprised 23 patients with degenerative spondylolisthesis (DS) at the level L4-5, group B comprised 40 patients above the age of 50 years, group C comprised 38 patients aged between 35 and 50 years, and group D comprised 31 patients under the age of 35 years. Groups B, C, and D had no evidence of DS. Measurements were taken from hard copies of axial MR or CT images. The transverse plane of facet joints was more sagittally oriented in group A than in any other group. This difference was highly significant at the L4-5 level. The incidence of more sagittally oriented L4-5 facet joints was also significantly higher only in group A. The incidence of facet joint tropism, however, was not different in group A. These results support the view that the pronounced sagittal alignment of facet joints in patients with DS represents a secondary remodeling rather than a pre-existing morphology. Facet joint asymmetry does not seem to play a major role in the development of DS.

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“…DS can be found in classifications of spondylolisthesis, spinal stenosis, and segmental instability, indicating that the clinical presentation is varied [19]. The degree of slip is usually mild, with a mean slip of 14% reported in a study of 200 patients [50]. As the neural arch is intact, even a small progression in the slip can result in cauda equina compression.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

2007

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Degenerative spondylolisthesis (DS) is a disorder that causes the slip of one vertebral body over the one below due to degenerative changes in the spine. Lumbar DS is a major cause of spinal canal stenosis and is often related to low back and leg pain. We reviewed the symptoms, prognosis and conservative treatments for symptoms associated with DS. PubMed and MEDLINE databases (1950-2007) were searched for

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Degenerative spondylolisthesis. Predisposing factors

Cited by 253 publications

References 0 publications

Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study

Geometry of the vertebral bodies and the intervertebral discs in lumbar segments adjacent to spondylolysis and spondylolisthesis: pilot study

Facet joint remodeling in degenerative spondylolisthesis: an investigation of joint orientation and tropism

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

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