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Influence of sacral morphology in developmental spondylolisthesis
Zhi Wang1, Stefan Parent, Jean-Marc Mac-Thiong
1Sainte-Justine University Center Hospital, Quebec, Canada.
Spine
|September 17, 2008
Summary
Sacral morphology differs in children with L5-S1 spondylolisthesis, with a smaller sacral table angle (STA) and increased sacral kyphosis potentially predisposing to vertebral slip.
Area of Science:
- Pediatric Orthopedics
- Spinal Anatomy
- Radiographic Imaging
Background:
- Adult sacral morphology abnormalities in spondylolisthesis are known.
- Pediatric sacral morphology in spondylolisthesis remains unevaluated.
- Primary vs. secondary changes in pediatric spondylolisthesis are unclear.
Purpose of the Study:
- To investigate sacral morphology in pediatric L5-S1 spondylolisthesis.
- To determine the relationship between sacral morphology and developmental L5-S1 spondylolisthesis.
Main Methods:
- Radiographic analysis of 131 children and adolescents (6-20 years) with L5-S1 spondylolisthesis.
- Comparison with 120 age- and sex-matched controls without spinal pathology.
- Measurement of sacral table index (STI), sacral table angle (STA), sacral kyphosis (SK), and S1/S2 angles.
Main Results:
- Significantly smaller sacral table angle (STA) in spondylolisthesis patients versus controls (P < 0.01).
- STA is smaller in high-grade versus low-grade spondylolisthesis.
- Increased sacral kyphosis is significantly associated with spondylolisthesis.
Conclusions:
- Sacral morphology is an individual, stable anatomic variable.
- Children and adolescents with L5-S1 spondylolisthesis exhibit distinct sacral anatomy.
- Lower STA and higher sacral kyphosis may predispose to vertebral slip in developmental spondylolisthesis.
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