Radiographic Assessment of Lumbar Facet Distance Spacing and Spondylolysis

Ward, Carol V.; Latimer, Bruce; Alander, Dirk H.; Parker, Jeffrey M.; Ronan, James A.; Holden, Anne D.; Sanders, Cary

doi:10.1097/01.brs.0000252200.66545.43

Cited by 44 publications

(32 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results corroborate previous tests of the hypothesis comparing spondylolytic and unaffected individuals from bones (Ward and Latimer, 2005) and clinical radiographs from adult (Ward et al, 2007) and pediatric (Zehnder et al, 2009) patient populations. These differences in interfacet distance between spondylolytic and unaffected individuals are not a reflection of differential increase in vertebral body size, as patterns are equivalent when interfacet distance is standardized by body diameter.…”

Section: Discussionsupporting

confidence: 92%

“…3 and 4). Unaffected spines show a greater differential increase in interfacet distance than spondylolytic ones at this lowest level, as seen in the Hamann Todd (Ward and Latimer, 2005) and clinical (Ward et al, 2007;Zehnder et al, 2009) populations. No different pattern is seen in BD (Table 2; Fig.…”

Section: Methodsmentioning

confidence: 91%

“…Data from skeletons from the Hamann Todd osteological collection at the Cleveland Museum of Natural History (Ward and Latimer, 2005), as well as radiographic data from modern clinical samples at the University of Missouri (Ward et al, 2007) and St. Louis University (Zehnder et al, 2009), demonstrate that even when controlling for vertebral size, spondylolytic individuals have a less pronounced increase in mediolateral separation between right and left articular facets in the lowest lumbar vertebrae than do unaffected individuals. The relationship of spondylolysis to facet spacing may also provide an explanation of the apparent genetic predisposition for developing this disorder (Haukipuro et al, 1978), and for the variation in prevalence among different populations (Merbs, 1996;Fibiger and Knü sel, 2005).…”

mentioning

confidence: 97%

See 2 more Smart Citations

Lumbar vertebral morphology and isthmic spondylolysis in a British medieval population

Ward

Mays

Child

et al. 2009

American J Phys Anthropol

Self Cite

View full text Add to dashboard Cite

The British medieval population from Wharram Percy, England, has a greater prevalence of isthmic spondylolysis (11.9% of skeletons, 8.5% at the L5 level) than in modern populations (3%-6%). This may in part be due to differences in activity patterns between groups. However, Ward and Latimer (Spine 30 [2005] 1808-1814) proposed that the likelihood of developing and maintaining spondylolytic defects is also influenced by a lack of sufficient increase in mediolateral separation between articular processes in the lowest lumbar segments, given the human lumbar lordosis. Here, we demonstrate that spondylolytic individuals from Wharram Percy tend to have a less pronounced difference between mediolateral facet joint spacing of adjacent segments in the lowest lumbar region than do unaffected individuals, as seen in modern clinical and skeletal populations. These comparisons suggest that regardless of lifestyle, insufficient mediolateral increase in facet spacing predisposes people to spondylolytic defects, and so interfacet spacing patterns may have predictive utility in a clinical context. We also compare the Wharram Percy sample to a modern sample from the Hamann Todd collection with a typically modern prevalence rate. Data do not support the hypothesis that the Wharram Percy individuals had a less pronounced interfacet increase than the Hamann Todd, although they do have narrower lumbar facet spacing at the lowest three levels. Further investigation of anatomical variation underlying population-specific prevalence rates needs to be conducted.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 91%

mentioning

confidence: 97%

See 1 more Smart Citation

Lumbar vertebral morphology and isthmic spondylolysis in a British medieval population

Ward

Mays

Child

et al. 2009

American J Phys Anthropol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Plain radiographs have shown poor sensitivity in detecting pars defects, and subsequent imaging is usually necessary in order to make the diagnosis [16]. Single positron emission computerized tomography (SPECT), CT and MRI are imaging studies which have all been used in conjunction with plain radiograph, and controversy exists over which diagnostic modality is most sensitive and specific for diagnosing spondylolysis.…”

Section: Radiographic Evaluationmentioning

confidence: 98%

Spondylolysis in the adolescent athlete

Kim

Green

2011

Current Opinion in Pediatrics

View full text Add to dashboard Cite

show abstract

“…Ward et al described an inadequate increase in the transverse interfacetal distance progressing caudally from L4 to S1, compared with normal control subjects, was found in the individuals with spondylolysis of L5. The inferior articular process of L4 and the superior articular process of S1 contact the same cross-sectional position of the L5 pars interarticularis in accordance with the reduction in the transverse interfacetal distance, so excessive pressure was applied on the isthmus due to pinching between the inferior articular process of the segment above and the superior articular process of the segment below, thus leading to bony resorption and bone weakness, finally resulting in lysis [20]. In the analysis of cadaveric skeletons with L5 spondylolysis, Masharawi et al noted that greater degrees of coronal orientation, facet tropism and symmetry of the lower lumbar facets was With elongation strongly associated with spondylolysis, and with increased contact surface area of the opposing articular processes because of coronally oriented facet joints: they postulated that more loading stress was being applied to the isthmus during flexion and extension.…”

Section: Etiologymentioning

confidence: 99%

Spondylolytic spondylolisthesis: various imaging features and natural courses

Nakayama

Ehara

2014

Jpn J Radiol

View full text Add to dashboard Cite

with spondylolysis and the other with degeneration of facet joints and/or intervertebral disc. Many patients with spondylolysis remain asymptomatic and certain cases become symptomatic, with low back pain and, less commonly, radicular pain. Spondylolisthesis can also be asymptomatic, but may cause low back pain, spinal instability, and radiculopathy, which requires conservative and/or surgical treatment.The incidence of lumbar spondylolysis has been reported to be 8 % in the adult population [2], and it was variable among races and sexes. Sakai et al. [3] reported that the prevalence of lumbar spondylolysis among the Japanese population between 20 and 29 years of age, found by multidetector CT, was 5.9 %, with a male to female ratio of 2:1. Spondylolysis has never been seen in newborn babies: it is seen only after walking. The upright posture and bipedal position play a role in the development of spondylolysis [4]. The prevalence of lumbar spondylolisthesis was reported to be 20.7 % in the adult population, and spondylolysis without spondylolisthesis was relatively uncommon and was only seen at the lower lumbar level [5].Although bone defects of typical isthmic spondylolysis run obliquely through the pars interarticularis, and are well depicted on oblique lumbar radiography, atypical isthmic defects have been reported in several papers [6,7]. The pathomechanism and incidence of atypical isthmic defects is not well known, and the radiographic appearance of atypical isthmic spondylolysis has not been well recognized among radiologists. Other atypical spondylolyses included various types, and two variations have been reported in the literature [8][9][10]. Unilateral spondylolysis accounts for 3-33 % of all cases of spondylolysis and has been estimated to be approximately 3-7 % of the general population [11]. It may be associated with certain athletic activities, such as cricket, ballet, and gymnastics, and the association with Abstract The purpose of this paper is to review typical and atypical imaging features of spondylolytic spondyolisthesis and natural courses. Imaging features of the typical pars defect in early phase include bone marrow edema of the isthmus on MR imaging with progression of bone defect on plain radiography or CT. There are various defect types (pedicular cleft, retroisthmic cleft) and locations (upper lumbar spine and unilateral lesions). Natural courses also vary, with different patterns of progression and stabilization. Clinical correlation of the imaging and clinical features is often difficult.

show abstract

Radiographic Assessment of Lumbar Facet Distance Spacing and Spondylolysis

Abstract: Spondylolytic fractures at L5 are influenced by an inadequate increase in interfacet distances between adjacent vertebrae. Individuals lacking sufficient increase in lower lumbar transverse interfacet dimensions are at greater risk of developing and maintaining spondylolytic defects.

Cited by 44 publications

References 22 publications

Lumbar vertebral morphology and isthmic spondylolysis in a British medieval population

Lumbar vertebral morphology and isthmic spondylolysis in a British medieval population

Spondylolysis in the adolescent athlete

Spondylolytic spondylolisthesis: various imaging features and natural courses

Contact Info

Product

Resources

About