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Case Study Gallery - Spondylolysis
According to research from Tel Aviv, Israel, "Opinions differ as
to the exact mechanism responsible for spondylolysis (SP) and whether
individuals with specific morphological characteristics of the lumbar
vertebral neural arch are predisposed to SP. The aim of our study was
to reveal the association between SP and the architecture of lumbar articular
facets and the inter-facet region."
Using a MicroScribe digitizer, length, width, and depth of all articular
facets and all inter-facet distances in the lumbar spine (L1-L5) were
measured. From the Hamann-Todd Human Osteological Collection (Cleveland
Museum of Natural History, OH, USA), 120 normal male skeletons with lumbar
spines in the control group and 115 with bilateral SP at L5 were selected.
Analysis of variance was employed to examine the differences between spondylolytic
and normal spines. Three profound differences between SP and the norm
appeared: (1) in individuals with SP, the size and shape of L4's neural
arch had significantly greater inter-facet widths, significantly shorter
inter-facet heights and significantly shorter and narrower articular facets;
(2) only in the L4 vertebra in individuals with SP was the inferior inter-facet
width greater in size than the superior inter-facet width of the vertebra
below (L5) (38.7 mm versus 40 mm); (3) in all lumbar vertebrae, the right
inferior articular facets in individuals with SP were flatter compared
to the control group.
The researchers concluded: "Individuals with L4 ''SP'' characteristics
are at a greater risk of developing fatigue fractures in the form of spondylolysis
at L5.
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