ABSTRACT
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To compare the prevalence of lumbar spondylolysis and spina bifida occulta (SBO) in pediatric and adult populations. SUMMARY OF BACKGROUND DATA: The prevalence of spondylolysis reported from radiograph-based studies in children had been questioned in computed tomography (CT)-based studies in adults; however, a recent CT-based study in pediatric patients has confirmed the previously reported data in pediatric populations. SBO, which has been associated with spondylolysis, has demonstrated a decreasing prevalence with increasing age during childhood and adolescence. No studies have compared the prevalence of spondylolysis and SBO in pediatric and adult patients using CT as a screening method. METHODS: We studied 228 pediatric patients (4-15 y old) and 235 adults (30-45 y old) who underwent abdominal and pelvic CT scans for reasons not related to the spine. The entire lumbosacral spine was evaluated to detect the presence of spondylolysis and SBO. We compared the prevalence of spondylolysis and SBO in pediatric patients and adults. RESULTS: The prevalence of spondylolysis in pediatric patients was 3.5% (1.1%-5.9%), and in adults, it was 3.8% (1.7%-6.8%), P=1. The prevalence of SBO in pediatric subjects was 41.2% (34.8%-59.2%) and dropped to 7.7% (4.3%-11.5%) in adults, P<0.01. The male prevalence of SBO in pediatric patients was 51.4%, whereas it was 32.2% in females (P<0.01); this sex difference was not significant in the adult population (P=0.8). CONCLUSIONS: The prevalence of lumbar spondylolysis remained constant from pediatric age through adulthood. The prevalence of SBO decreased from 41.2% in children to 7.7% in adults; this finding suggests that closure of the vertebral arch may not be completed in early childhood in a large percentage of subjects.
Subject(s)
Spina Bifida Occulta/epidemiology , Spondylolysis/epidemiology , Adult , Child , Child, Preschool , Female , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/pathology , Male , Middle Aged , Prevalence , Spina Bifida Occulta/diagnostic imaging , Spondylolysis/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
PURPOSE: The prevalence of spondylolysis reported from radiograph-based studies has been questioned in recent computed tomography (CT)-based studies in adults; however, no new data are available in pediatric patients. Spina bifida occulta (SBO), which has been associated to spondylolysis, may be increasing its prevalence, according to recent studies in adults in the last decades, but without new data in pediatric patients. We aimed to determine the prevalence of spondylolysis and SBO in pediatric patients using abdomen and pelvis CT as a screening tool. METHODS: We studied 228 patients 4-15 years old (107 males), who were evaluated with abdomen and pelvis CT scans for reasons not related to the spine. The entire lumbo-sacral spine was evaluated to detect the presence of spondylolysis and SBO. We compared the prevalence of spondylolysis in patients with and without SBO. A logistic regression analysis was performed to determine the effect of age and sex as independent predictors of spondylolysis and SBO. RESULTS: The prevalence of spondylolysis was 3.5 % (1.1-5.9 %); 2/8 patients presented with olisthesis, both with grade I slip. The prevalence of SBO was 41.2 % (34.8-59.2 %) (94 patients). Spondylolysis was not more frequent in patients with SBO than in patients without SBO. Male sex and decreasing age independently predicted the presence of SBO, but not of spondylolysis. CONCLUSION: We observed a 3.5 % prevalence of spondylolysis and a 41.2 % prevalence of SBO. SBO was significantly more frequent in males and younger patients.
Subject(s)
Spina Bifida Occulta/epidemiology , Spondylolysis/epidemiology , Adolescent , Age Factors , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Logistic Models , Lumbar Vertebrae/diagnostic imaging , Male , Mass Screening , Prevalence , Sex Factors , Spina Bifida Occulta/diagnosis , Spina Bifida Occulta/diagnostic imaging , Spondylolysis/diagnosis , Spondylolysis/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
El presente trabajo tiene por objeto repasar conceptos relacionados con el exámen radiológico del raquis lumbosacro desde el punto de vista laboral y a la luz de la legislación vigente en la actualidad (Ley de riesgo de trabajo Nº 24557, capítulo III artículo 6). También hace hincapié en la responsabilidad que le cabe al especialista en diagnóstico por imágenes en todo lo referente a la detección de patología osteoarticular presente en el momento del exámen y/o condiciones anatómi
Subject(s)
Humans , Lumbosacral Region/diagnostic imaging , Lumbar Vertebrae/diagnostic imaging , Sacrum/diagnostic imaging , Lumbosacral Region/abnormalities , Lumbar Vertebrae/abnormalities , Sacrum/abnormalities , Occupational Medicine , Occupational Groups , Spine/abnormalities , Spine/diagnostic imaging , Spine/embryology , Spondylolysis/diagnostic imaging , Spondylolisthesis/diagnostic imagingABSTRACT
The authors present the results of treatment of seven cases of spondylolysis with a two years follow up. Six patients were treated with the thoracolumbosacral orthosis and one with L5-S1 fusion. At the end of the follow up all patients were pain free.