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The prevalence of lumbar spondylolysis in young children: a retrospective analysis using CT

European Spine Journal volume 27, pages 1067–1072 (2018)Cite this article

Abstract

Purpose

Although lumbar spondylolysis is encountered in general population with an incidence estimated to be 3–10%, limited information is available for children. The aim of the study is to determine the prevalence of spondylolysis according to associated vertebral bony malformation and spinopelvic parameters in children under eight requiring CT evaluation for unrelated lumbar conditions.

Methods

Seven hundred and seventeen abdominal and pelvic multi-detector CT scans were obtained in patients under 8 years of age were reviewed. Two board certificated radiologists and two resident radiologists retrospectively evaluated CT scans for lumbar spondylolysis and associated malformations. Pelvic incidence and spondylolisthesis were reported.

Results

Our analysis included 717 CT scans in 532 children (259 girls and 273 boys). Twenty-five cases of spondylolysis were diagnosed (16 bilateral and 9 unilateral, 64 and 36%, respectively) in 14 boys (56%) and 11 girls (44%), associating with 12 grade I spondylolisthesis. The mean normal pelvic incidence was 45° (median 44°, SD 7°). The prevalence of spondylolysis was 1% in children under age 3 (n = 3 among 292 patients), 3.7% in children under age 6 (n = 17 among 454 patients) and 4.7% among the 532 patients. Unilateral spondylolysis was significantly associated with a spinal malformation (p = 0.04, Fisher’s exact test), with normal pelvic incidence. Half of the patients with bilateral spondylolysis had high pelvic incidence.

Conclusions

We observed a prevalence peak of unilateral spondylolysis in the context of a specific malformation in young infants under age 4 with normal pelvic incidence, and, then, a progressive increase in the prevalence of bilateral isolated spondylolysis.

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Acknowledgements

The authors thank John C. Scatarige and John Sheath for English language assistance and their friendly support.

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Affiliations

  1. Department of Pediatric Radiology, Clocheville Hospital, CHRU Tours, 49 Boulevard Beranger, 37000, Tours, France

    Thibaut Lemoine, Catherine Sembély-Taveau, Pauline Merenda, Dominique Sirinelli & Baptiste Morel

  2. Department of Spinal Surgery, The Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, England, UK

    Joseph Fournier

  3. Department of Pediatric Orthopedic Surgery, CHRU Tours, 49 Boulevard Beranger, Tours, France

    Thierry Odent

  4. Faculty of Medicine, Francois Rabelais University, Tours, France

    Thierry Odent, Dominique Sirinelli & Baptiste Morel

Authors
  1. Thibaut Lemoine
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  2. Joseph Fournier
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  3. Thierry Odent
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  4. Catherine Sembély-Taveau
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  5. Pauline Merenda
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  6. Dominique Sirinelli
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  7. Baptiste Morel
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Corresponding author

Correspondence to Baptiste Morel.

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No funding was secured for this study.

Conflict of interest

The authors have no conflicts of interest to disclose. The authors have no financial relationships relevant to this article to disclose.

Ethical statement

The local institutional review board approved this single center, non-interventional, retrospective cross sectional study.

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Lemoine, T., Fournier, J., Odent, T. et al. The prevalence of lumbar spondylolysis in young children: a retrospective analysis using CT. Eur Spine J 27, 1067–1072 (2018). https://doi.org/10.1007/s00586-017-5339-5

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  • DOI: https://doi.org/10.1007/s00586-017-5339-5

Keywords

  • Spondylolysis
  • Spondylolisthesis
  • Pelvic parameters
  • Children
  • Computed tomography