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Sacral orientation and spondylolysis.

Smadar Peleg1, Gali Dar, Nili Steinberg

  • 1Department of Anatomy and Anthropology, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel. smadarpeleg@yahoo.com

Spine
|November 27, 2009
PubMed
Summary
This summary is machine-generated.

A more horizontal sacral anatomic orientation (SAO) is linked to a higher prevalence of spondylolysis. This finding suggests SAO may play a role in the development of this spinal condition.

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Area of Science:

  • Orthopedics
  • Anatomy
  • Radiology

Background:

  • Spondylolysis, a stress fracture of the pars interarticularis, has a debated etiology, with theories including developmental origins versus mechanical stress.
  • Sacral orientation is hypothesized to influence the biomechanics leading to spondylolysis.
  • Understanding the relationship between sacral anatomy and spondylolysis is crucial for elucidating its pathogenesis.

Purpose of the Study:

  • To investigate the association between sacral anatomic orientation (SAO) and the presence of spondylolysis.
  • To determine if individuals with spondylolysis exhibit a different SAO compared to those without the condition.

Main Methods:

  • A descriptive study utilizing skeletal material to measure SAO.
  • SAO was quantified as the angle between the superior sacral surface and a line connecting the anterior superior iliac spine to the pubic symphysis.
  • Measurements were taken from 99 adult males with spondylolysis and 125 without, with statistical comparison using an unpaired t-test.

Main Results:

  • Spondylolysis prevalence was significantly higher in African-Americans than European-Americans across both sexes.
  • Individuals with spondylolysis demonstrated a significantly lower SAO (44.07° ± 11.46°) compared to the control group (51.07° ± 8.46°).
  • The difference in SAO between the spondylolytic and control groups was statistically significant (P < 0.001).

Conclusions:

  • A more horizontally oriented sacrum is associated with spondylolysis.
  • This orientation may lead to impingement on the L5 pars interarticularis by adjacent vertebral facets.
  • Repetitive stress from daily activities on this compromised area could contribute to the development of spondylolysis.