Abstract
Background: There is insufficient current information regarding the prognosis of patients with lumbar spondylolysis when bone union is not achieved. To examine the number, age, and surgically treated levels of patients with lumbar degenerative disease who underwent lumbar spine surgery, and to compare the results between patients with spondylolysis and without spondylolysis, a cross-sectional study was performed.Methods: Patients with degenerative lumbar disease who underwent lumbar spine surgery were retrospectively reviewed (n=354). The prevalence of spondylolysis was determined using CT images. Patients were divided into a spondylolysis group and a non-spondylolysis group, and the patients’ age, sex, and surgically treated levels were compared between the two groups.Results: The prevalence of lumbar spondylolysis in the 354 patients was 6.50% (23/354). The patients’ age was significantly lower in the spondylolysis group (54.2 ± 13.5 years) than in the non-spondylolysis group (63.8 ± 14.2). The number of surgically treated levels was significantly lower in the spondylolysis group (1.33 ± 0.56 levels) than in the non-spondylolysis group (1.70 ± 0.87). The percentage of patients who underwent surgery at L5-S1 was significantly higher in the spondylolysis group; whereas the percentage of patients who underwent surgery at L3-L4 or L4-L5 was significantly higher in the non-spondylolysis group.Conclusions: Our results suggest that the presence of spondylolysis may not increase the incidence of degenerative lumbar spinal disorders requiring spinal surgery. However, spondylolysis patients frequently have severe degenerative disease at one level caudal to the spondylolysis, and infrequently have multilevel lumbar degenerative disease requiring spinal surgery.
Highlights
Lumbar spondylolysis, a stress fracture of the pars interarticularis, is one of the common causes of low back pain in adolescent patients [1]
Of the 23 patients having spondylolysis, bilateral spondylolysis was found in 19 patients and unilateral spondylolysis was found in four patients
Lumbar degenerative disease patients requiring spinal surgery showed similar prevalence of spondylolysis (6.5%) compared to the general population (5.9-6.4%) [9,11]. These data suggest that the occurrence of severe degenerative lumbar disease requiring spinal surgery in patients with pseudoarthrotic spondylolysis is not higher than that in patients without spondylolysis. These results suggest that the rate of patients who develop lumbar spinal disorders requiring future surgery may not increase when bony union is not achieved in acute spondylolysis patients
Summary
A stress fracture of the pars interarticularis, is one of the common causes of low back pain in adolescent patients [1]. Acute lumbar spondylolysis is usually treated conservatively by the use of a brace and refraining from sports; this, often takes long periods of time (three to six months) [4,5]. The fracture does not heal and it becomes a pseudoarthrosis (pseudoarthrotic spondylolysis) [5] In such cases, the patients (or their parents) may have justified anxiety about their future. At this moment, there is little information about the influence of lumbar spondylolysis on the future occurrence of lumbar degenerative disease in cases where the defect has become a pseudoarthrosis. There is insufficient current information regarding the prognosis of patients with lumbar spondylolysis when bone union is not achieved. Age, and surgically treated levels of patients with lumbar degenerative disease who underwent lumbar spine surgery, and to compare the results between patients with spondylolysis and without spondylolysis, a cross-sectional study was performed
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