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

Abstract

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.

The relationship between sagittal spinopelvic parameters and the degree of lumbar intervertebral disc degeneration in young adult patients with low-grade spondylolytic spondylolisthesis

“…Disc degeneration was therefore aggravated by lumbosacral kyphosis. Been et al 28 studied the geometry of the vertebral bodies and intervertebral discs in patients with spondylolisthesis. They reported that in isthmic spondylolysis, when the vertebra started to slide forward the compensating mechanism of the lumbar spine was to increase the lumbar lordosis by increasing the wedging of the intervertebral disc above the slipped vertebra.…”

Significance of interfacet distance, facet joint orientation, and lumbar lordosis in spondylolysis

“…In their study, there was no difference of IFD at the L3, L4, and L5 level between spondylolytic and unaffected individuals. The most recent article about spondylolysis demonstrated that spinal morphology of individuals with L5 spondylolysis without listhesis is similar to that of individuals with normal lower spinal segments in the context of total lordotic angle, vertebral body wedging, and intervertebral disc wedging but did not address on IFD as major geometrical variable (Been et al, 2011). Masharawi et al reported some association between spondylolysis and the architecture of lumbar articular facets and interfacet region (Masharawi et al,2007a).…”

Morphological and postural sexual dimorphism of the lumbar spine facilitates greater lordosis in females

“…On lateral radiographs, we measured lumbar angle, vertebral body wedging, intervertebral disc wedging, sacral slope and pelvic incidence ( Fig. 1; variables defined in previous studies; Vialle et al 2005;Been et al 2011Been et al , 2010O'Brien et al 2004;De Carvalho et al 2010). Lumbar angle (LA) is a way to assess LL and was defined as the Cobb angle between the L1 cranial endplate and S1 cranial endplate.…”