Abstract:
STUDY DESIGN:A radiographic study was conducted to investigate sacral morphology in a children and adolescent population with developmental L5-S1 spondylolisthesis. OBJECTIVE:To determine the relationship between sacral morphology and developmental L5-S1 spondylolisthesis. SUMMARY AND BACKGROUND DATA:The morphology of the adult sacrum has been recently shown to be abnormal in low grade spondylolisthesis. However, sacral morphology has never been evaluated in a pediatric population where remodeling and secondary changes are less pronounced. It remains unknown if these changes in sacral morphology are primary or secondary in developmental L5-S1 spondylolisthesis. METHODS:The lateral standing radiographs of 131 subjects, aged 6 to 20 years old with developmental L5-S1 spondylolisthesis (91 low grade and 40 high grade) were analyzed with a dedicated software allowing to measure the following parameters, which were analyzed for each subject by the same individual and compared to a cohort of 120 subjects without any spinal pathology with similar age and sex distribution: the sacral table index (STI), sacral table angle (STA), sacral kyphosis (SK), S1 superior angle, S2 inferior angle, and grade of spondylolisthesis. Student t test was used to compare the parameters between the groups. RESULTS:This study demonstrated that STA is significantly smaller (P < 0.01) in children and adolescents with L5-S1 spondylolisthesis compared to a similar control group. Furthermore, STA is significantly smaller in high-grade spondylolisthesis when compared to subjects with low grade. There is also a significant difference in segmental sacral morphology (S1 and S2 anatomy) in the spondylolisthesis group. Increasing sacral kyphosis is also found to be significantly associated with spondylolisthesis. CONCLUSION:The sagittal sacral morphology is a constant anatomic variable specific to each individual and unaffected by the position of the patient in space. The anatomy of the sacrum in children and adolescents with L5-S1 spondylolisthesis is particular and different from a control group. This study suggests that sacral anatomy may have a direct influence on the progression of spondylolisthesis; a lower STA and higher sacral kyphosis may be 2 factors predisposing to vertebral slip in developmental spondylolisthesis.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Wang Z,Parent S,Mac-Thiong JM,Petit Y,Labelle Hdoi
10.1097/BRS.0b013e3181857f70subject
Has Abstractpub_date
2008-09-15 00:00:00pages
2185-91issue
20eissn
0362-2436issn
1528-1159pii
00007632-200809150-00010journal_volume
33pub_type
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