The Importance of Mechanical Factors in the Etiology of Spondylolysis

Dietrich, Marek; Kurowski, Pawel

doi:10.1097/00007632-198507000-00007

Cited by 101 publications

(16 citation statements)

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“…If this is accepted, the spondylolysis at T12 and L1 in the current material was congenital, as was one of the L3 cases and one case at L5. That there was no evidence of acquired lesions cranial to L3 may be consistent with observations that mechanical forces born by lumbar elements decrease cranially (Farfan et al, 1976;Dietrich & Kurowski, 1985). L3 is, in a sense, a transitional segment, showing here one lesion of congenital type and two which, on morphological grounds, resembled the acquired type seen in lower lumbar segments.…”

Section: Discussionsupporting

confidence: 87%

“…Historically, there has been considerable debate regarding the aetiology of the lesion (Newell, 1995), but there is currently agreement that spondylolysis in the lower lumbar spine represents a fatigue fracture of the neural arch (Merbs, 1996;Standaert & Herring, 2000). The preferential location for lesions in the last lumbar segment can be understood in biomechanical terms: the greatest mechanical forces are born by motion segment S1/L5 and decrease in successively more cranial segments (Farfan et al, 1976;Dietrich & Kurowski, 1985), and the L5 isthmus is anatomically weaker than at other levels (Ebraheim et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

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Spondylolysis in the lower thoracic–upper lumbar spine in a British medieval population

Mays

2007

Intl J of Osteoarchaeology

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Spondylolysis is generally a condition of the lower lumbar spine, but occasionally it is observed at cranial to L4. It is generally agreed that spondylolysis in the lower lumbar spine represents fatigue failure of the neural arch. However, whether a biomechanical explanation is adequate to explain lesions cranial to L4 is disputed. Morphological aspects of spondylolysis at T12-L3 (five cases) are compared with those of lesions at L4-L6 (24 cases) in a mediaeval English skeletal series with the aim of shedding light upon any differences in aetiology of lesions at the two sites. It was found that spondylolysis at T12-L3 was more often unilateral than in L4-L6. In T12-L3, clefts more often took an angulated, dog-leg course across the pars interarticularis, whereas most in L4-L6 were fairly straight and had an oblique orientation. In T12-L3, clefts often had facetted opposing surfaces suggestive of a diarthrodial joint, but this was only seen once in L4-L6. It is suggested on morphological grounds that facetted defects are more likely congenital than acquired. The need for consideration of factors in addition to activity regimes when interpreting spondylolysis in earlier populations is emphasised.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Spondylolysis in the lower thoracic–upper lumbar spine in a British medieval population

Mays

2007

Intl J of Osteoarchaeology

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“…The cancellous bone in the vertebral body undergoes complementary structural changes with increasing disc disorganisation. In vertebrae with morphologically disorganised discs, the effective stresses are in the peripheral area of the endplate, in the cortical wall and in the vertebral rim (Coventry et al, 1945; Dietrich and Kurowski, 1985; Kurowski and Kubo, 1986; Adams, 1995). Rockoff et al (1969) reported that less load was transmitted through the central region of the vertebral body in older individuals.…”

Section: Discussionmentioning

confidence: 99%

Intervertebral disc disorganisation and its relationship to age adjusted vertebral body morphometry and vertebral bone architecture

2001

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Vertebral deformity, intervertebral disc disorganisation, and change to vertebral bone architecture are morphological features that are associated with low back pain. The purpose of this study was to examine the influence of the morphological disorganisation of the intervertebral disc on vertebral body shape indices and vertebral cancellous bone architecture. Lumbar spines, T12–S1, were collected from 27 cadavers. The motion segments T12–L1, L2–L3 and L4–L5 were selected for the study. There were 8 females aged 35–94 years and 19 males aged 20–90 years. An intervertebral disc grade signifying the severity of disc disorganisation was assigned to each disc using the macroscopic disc grading criteria of Hansson and Roos (Spine, 1981; 6:147–153.). Vertebral shape indices and vertebral body bone histomorphometric analyses were performed on the vertebral bodies. Where appropriate, data were age adjusted and the influence of morphological disc disorganisation on vertebral body deformity and cancellous bone architecture analysed. Increased vertebral body axial area and the ratio of vertebral body axial area to sagittal area were associated with an increase in vertebral deformity and disc disorganisation. This suggests that vertebral deformity that remains clinically silent in the general population is influenced by intervertebral disc disorganisation. Vertebral cancellous bone architecture undergoes change associated with increased disc disorganisation, consistent with increased vertebral deformity. Vertebral bodies adjacent to degenerate discs (Grade 4) showed increased BV/TV and Tb.Th and decreased BS/BV. This shows that disc disorganisation may modulate vertebral cancellous bone architecture such that it protects against age‐related bone changes. In addition, vertebral body wedging and concavity are associated with smaller vertebral body size and vertebral body compression is associated with larger vertebral body size and compromised cancellous bone architecture. Anat Rec 262:331–339, 2001. © 2001 Wiley‐Liss, Inc.

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“…The position of pedicles between loadbearing ventral pillars, formed by centra and intervertebral discs, and dorsal pillars, comprised of zygapophyses and laminae (see Kapandji, 1974;Pal & Routal, 1986Sanders, 1990;Shapiro, 1990Shapiro, , 1993a, places them under constant bending stress ( Figure 10; see Bogduk & Twomey, 1987). In upright posture, the lordotic curve of the human lumbar column situates the zygapophyses closer to the center of vertical compression than is the condition in other catarrhines; correspondingly, human lumbar zygapophyses bear a more substantial 277 -8/41   portion of the intervertebral compressive load (see Adams & Hutton, 1980;Yang & King, 1984;Dietrich & Kurowski, 1985), especially at the level of the last lumbar vertebra. In humans, the last lumbar zygapophyses passively carry as much as 23% of the load borne by the spine (Pal & Routal, 1987).…”

mentioning

confidence: 99%

Comparative morphometric study of the australopithecine vertebral series Stw-H8/H41

Sanders¹

1998

Journal of Human Evolution

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The Importance of Mechanical Factors in the Etiology of Spondylolysis

Cited by 101 publications

References 0 publications

Spondylolysis in the lower thoracic–upper lumbar spine in a British medieval population

Spondylolysis in the lower thoracic–upper lumbar spine in a British medieval population

Intervertebral disc disorganisation and its relationship to age adjusted vertebral body morphometry and vertebral bone architecture

Comparative morphometric study of the australopithecine vertebral series Stw-H8/H41

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