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The natural history of spondylolysis and spondylolisthesis
Insights
This study found that spondylolysis and spondylolisthesis are common in children, with incidence increasing into adulthood. The defects appear to have a hereditary basis and are linked to spina bifida occulta.
Area of Science:
- Orthopedics
- Radiology
- Pediatric Spine Research
Background:
- Spondylolysis and spondylolisthesis are common spinal conditions.
- Understanding their incidence and progression in childhood is crucial.
Purpose of the Study:
- To determine the incidence of spondylolysis and spondylolisthesis in first-grade children.
- To investigate the progression and associated factors of these spinal defects.
Main Methods:
- Prospective roentgenographic study of 500 unselected first-grade children.
- Longitudinal follow-up of children with spondylolysis and their families.
Main Results:
- Spondylolysis incidence was 4.4% at age six, rising to 6% in adulthood.
- Spondylolisthesis reached up to 28%, with unusual progression.
- A hereditary predisposition and association with spina bifida occulta were noted.
Conclusions:
- The spondylolytic defect may originate from vertebral cartilaginous anlage.
- Progression of slips is unlikely after adolescence and rarely symptomatic in this cohort.
Abstract:
We performed a prospective roentgenographic study to determine the incidence of spondylolysis, spondylolisthesis, or both, in 500 unselected first-grade children from 1955 through 1957. The families of the children with spondylolysis were followed in a similar manner. The incidence of spondylolysis at the age of six years was 4.4 per cent and increased to 6 per cent in adulthood. The degree of spondylolisthesis was as much as 28 per cent, and progression of the olisthesis was unusual. The data support the hypothesis that the spondylolytic defect is the result of a defect in the cartilaginous anlage of a vertebra. There is a hereditary pre-disposition to the defect and a strong association with spina bifida occulta. Progression of a slip was unlikely after adolescence and the slip was never symptomatic in the population that we studied.