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Incidence and etiology of lumbar spondylolysis: review of the literature

  • Review Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Lumbar spondylolysis is a defect of the pars interarticularis known to occur as a stress fracture. Its incidence varies considerably depending on ethnicity, sex, and sports activity. However, there are few literature reviews describing its incidence in different ethnic groups or in people who engage in different sports.

Methods

We reviewed the most relevant articles on spondylolysis published in scientific journals. First, we focused on its incidence in various ethnic groups distributed by sex, the familial occurrence, and in patients with relevant diseases. Second, we focused on the incidence of spondylolysis in relation to the sports practiced by the patients. Although placing special emphasis on the incidence of lumbar spondylolysis in the general population in Japan, we also reviewed the Japanese and English literature to investigate its incidence among those who engage in different sports.

Results

The incidence of lumbar spondylolysis in the general Japanese population was 5.9%. Most studies report that the incidence in higher in male subjects than in female subjects. We found that Japanese rugby and judo players were prone to suffer lumbar spondylolysis, at an incidence of about 20%. However, the incidence for Japanese professional soccer and baseball players was much higher, at 30%, which was more than five times the incidence in the general Japanese population.

Conclusions

The incidence of lumbar spondylolysis varies depending on ethnicity, sex, family history, relevant disease, and sports activity.

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References

  1. Wiltse LL, Widell EH Jr, Jackson DW. Fatigue fracture: the basic lesion in isthmic spondylolisthesis. J Bone Joint Surg Am 1975;57:17–22.

    CAS  PubMed  Google Scholar 

  2. Hasebe K. Die Wirbelsaule der Japaner. Z Morphol Anthropol 1913;15:259–380.

    Google Scholar 

  3. Matsui N, Watanabe T, Takahashi K, Takayama A. Analysis of symptoms in patients with lumbar spondylolysis and isthmic spondylolisthesis. Seikeigeka MOOK 1984;33:43–57 (in Japanese).

    Google Scholar 

  4. Suzuki T. Indicators of stress in prehistoric Jomon skeletal remains in Japan. Anthropol Sci 1998;106(suppl):127–137.

    Google Scholar 

  5. Roche MB, Rowe GG. The incidence of separate neural arch and coincident bone variations; a survey of 4,200 skeletons. Anat Rec 1951;109:233–252.

    Article  CAS  PubMed  Google Scholar 

  6. Eisenstein S. Spondylolysis: a skeletal investigation of two population groups. J Bone Joint Surg Br 1978;60:488–494.

    PubMed  Google Scholar 

  7. Arriaza BT. Spondylolysis in prehistoric human remains from Guam and its possible etiology. Am J Phys Anthropol 1997;104:393–397.

    Article  CAS  PubMed  Google Scholar 

  8. Gunness-Hey M. The Koniag Eskimo presacral vertebral column: variations, anomalies and pathologies. OSSA 1980;7:99–118.

    Google Scholar 

  9. Lester CW, Shapiro HL. Vertebral arch defects in the lumbar vertebrae of pre-historic American Eskimos: a study of skeletons in the American Museum of Natural History, chiefly from Point Hope, Alaska. Am J Phys Anthropol 1968;28:43–48.

    Article  CAS  PubMed  Google Scholar 

  10. Merbs CF. Patterns of activity-induced pathology in a Canadian Inuit population. Archaeol Surv Canada 1983;119:120–128.

    Google Scholar 

  11. Stewart TD. Incidence of separate neural arch in the lumbar vertebrae of Eskimos. Am J Phys Anthropol 1931;16:51–62.

    Article  Google Scholar 

  12. Simper LB. Spondylolysis in Eskimo skeletons. Acta Orthop Scand 1986;57:78–80.

    Article  CAS  PubMed  Google Scholar 

  13. Takahashi S, Terayama K, Otsuka K, Wada K, Kinoshita H. An epidemiological survey on spondylolisthesis of the lumbar spine using the X-rays of health-check survices. Chubu Nihon Seikeigeka Saigaigeka Gakkai Zasshi (Cent Jpn J Orthop Traumatol) 1990;33:728–730 (in Japanese).

    Google Scholar 

  14. Ogata N, Fujita M, Yamamoto S. Epidemiology of lumbar spondylolysis. MB Orthop 2007:20:1–6 (in Japanese).

    Google Scholar 

  15. Okuda T, Fujita T, Kaneuji A, Hosokawa E, Ichizeki T, Fukui K, et al. The frequency of lumbar spondylolysis, spondylolisthesis and degenerative scoliosis with the osteoarthritis of the hip. 38th annual meeting of the Japanese Society for Spine Surgery and Related Research 2009;20:116 (in Japanese).

    Google Scholar 

  16. Akimoto T. The etiology of spondylolysis with reference to athletic activities during growing period. Seikeigeka (Orthopaedics) 1979;30:638–646 (in Japanese).

    Google Scholar 

  17. Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am 1984;66:699–707.

    CAS  PubMed  Google Scholar 

  18. Sonne-Holm S, Jacobsen S, Rovsing HC, Monrad H, Gebuhr P. Lumbar spondylolysis: a life long dynamic condition? A cross sectional survey of 4,151 adults. Eur Spine J 2007;16:821–828.

    Article  PubMed  Google Scholar 

  19. Amato M, Totty WG, Gilula LA. Spondylolysis of the lumbar spine: demonstration of defects and laminal fragmentation. Radiology 1984;153:627–629.

    CAS  PubMed  Google Scholar 

  20. Libson E, Bloom RA, Shapiro Y. Scoliosis in young men with spondylolysis or spondylolisthesis: a comparative study in symptomatic and asymptomatic subjects. Spine (Phila Pa 1976) 1984;9:445–447.

    CAS  Google Scholar 

  21. Weil Y, Weil D, Donchin M, Mann G, Hasharoni A. Correlation between pre-employment screening X-ray finding of spondylolysis and sickness absenteeism due to low back pain among policemen of the Israeli police force. Spine (Phila Pa 1976) 2004;29:2168–2172.

    Google Scholar 

  22. Sakai T, Sairyo K, Takao S, Nishitani H, Yasui N. Incidence of lumbar spondylolysis in the general population in Japan based on multi-detector CT scans from 2000 subjects. Spine (Phila Pa 1976) 2009;34:2346–2350.

    Google Scholar 

  23. Kalichman L, Kim DH, Li L, Guermazi A, Berkin V, Hunter DJ. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine (Phila Pa 1976) 2009;34:199–205.

    Google Scholar 

  24. Belfi LM, Ortiz AO, Katz DS. Computed tomography evaluation of spondylolysis and spondylolisthesis in asymptomatic patients. Spine (Phila Pa 1976) 2006;31:E907–E910.

    Google Scholar 

  25. Mays S. Spondylolysis, spondylolisthesis, and lumbo-sacral morphology in a medieval English skeletal population. Am J Phys Anthropol 2006;131:352–362.

    Article  CAS  PubMed  Google Scholar 

  26. Sairyo K, Goel VK, Vadapalli S, Vishnubhotla SL, Biyani A, Ebraheim N, et al. Biomechanical comparison of lumbar spine with or without spina bifida occulta: a finite element analysis. Spinal Cord 2006;44:440–444.

    CAS  PubMed  Google Scholar 

  27. Burkus JK. Unilateral spondylolysis associated with spina bifida occulta and nerve root compression. Spine (Phila Pa976) 1990;15:555–559.

    CAS  Google Scholar 

  28. Bollerslev J, Mosekilde L. Autosomal dominant osteopetrosis. Clin Orthop 1993;294:45–51.

    PubMed  Google Scholar 

  29. Szappanos L, Szepesi K, Thomázy V. Spondylolysis in osteopetrosis. J Bone Joint Surg Br 1988;70:428–430.

    CAS  PubMed  Google Scholar 

  30. Martin R, Deane R, Collett V. Spondylolysis in children who have osteopetrosis. J Bone Joint Surg Am 1997;79:1685–1689.

    CAS  PubMed  Google Scholar 

  31. Verra WC, Pruijs HJ, Beek EJ, Castelein RM. Prevalence of vertebral pars defects (spondylolysis) in a population with osteogenesis imperfecta. Spine (Phila Pa 1976) 2009;34:1399–1401.

    Google Scholar 

  32. Rosenberg NJ, Bargar WL, Friedman B. The incidence of spondylolysis and spondylolisthesis in nonambulatory patients. Spine (Phila Pa 1976) 1981;6:35–38.

    CAS  Google Scholar 

  33. Takada S, Katayama S, Kurose Y. The incidence of spondylolysis in cerebral palsied patients (children and adults). Chubu Nihon Seikeigeka Saigaigeka Gakkai Zasshi (Cent Jpn J Orthop Traumatol) 1985;28:476–478 (in Japanese).

    Google Scholar 

  34. Sakai T, Yamada H, Nakamura T, Nanamori K, Kawasaki Y, Hanaoka N, et al. Lumbar spinal disorders in patients with athetoid cerebral palsy: a clinical and biomechanical study. Spine (Phila Pa 1976) 2006;31:E66–E70.

    Google Scholar 

  35. Harada T, Ebara S, Anwar MM, Kajiura I, Oshita S, Hiroshima K, et al. The lumbar spine in spastic diplegia: a radiographic study. J Bone Joint Surg Br 1993;75:534.

    CAS  PubMed  Google Scholar 

  36. Ogilvie JW, Sherman J. Spondylolysis in Scheuermann’s disease. Spine (Phila Pa 1976) 1987;12:251–253.

    CAS  Google Scholar 

  37. Greene TL, Hensinger RN, Hunter LY. Back pain and vertebral changes simulating Scheuermann’s disease. J Pediatr Orthop 1985;5:1–7.

    CAS  PubMed  Google Scholar 

  38. Seitsalo S, Osterman K, Poussa M. Scoliosis associated with lumbar spondylolisthesis: a clinical survey of 190 young patients. Spine (Phila Pa 1976) 1988;13:899–904.

    CAS  Google Scholar 

  39. Fisk JR, Moe JH, Winter RB. Scoliosis, spondylolysis, and spondylolisthesis: their relationship as reviewed in 539 patients. Spine (Phila Pa 1976) 1978;3:234–245.

    CAS  Google Scholar 

  40. Shahriaree H, Sajadi K, Rooholamini SA. A family with spondylolisthesis. J Bone Joint Surg Am 1979;61:1256–1258.

    CAS  PubMed  Google Scholar 

  41. Wynne-Davies R, Scott JH. Inheritance and spondylolisthesis: a radiographic family survey. J Bone Joint Surg Br 1979;61:301–305.

    PubMed  Google Scholar 

  42. Albanese M, Pizzutillo PD. Family study of spondylolysis and spondylolisthesis. J Pediatr Orthop 1982;2:496–499.

    CAS  PubMed  Google Scholar 

  43. Rowe GG, Roche MB. The etiology of separate neural arch. J Bone Joint Surg Am 1953;35:102–110.

    PubMed  Google Scholar 

  44. Kaneko F. Studies on the relation between spondylolysis and developmental anatomies of lumbosacral region. J Jpn Orthop Assoc 1977;51:1237–1253 (in Japanese).

    Google Scholar 

  45. Jackson DW, Wiltse LL, Cirincoine RJ. Spondylolysis in the female gymnast. Clin Orthop 1976;117:68–73.

    PubMed  Google Scholar 

  46. Semon RL, Spengler D. Significance of lumbar spondylolysis in college football players. Spine (Phila Pa 1976) 1981;6:172–174.

    CAS  Google Scholar 

  47. Micheli LJ, Wood R. Back pain in young athletes: significant differences from adults in causes and patterns. Arch Pediatr Adolesc Med 1995;149:15–18.

    CAS  PubMed  Google Scholar 

  48. Seitsalo S, Antila H, Karrinaho T, Riihimäki, Schlenzka D, Österman K, et al. Spondylolysis in ballet dancers. J Dance Med Sci 1997;1:51–54.

    Google Scholar 

  49. Soler T, Calderon C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med 2000;28:57–62.

    CAS  PubMed  Google Scholar 

  50. Teitz CC. Sports medicine concerns in dance and gymnastics. Pediatr Clin North Am 1982;29:1399–1421.

    CAS  PubMed  Google Scholar 

  51. Sairyo K, Katoh S, Komatsubara S, Terai T, Yasui N, Goel VK, et al. Spondylolysis fracture angle in children and adolescents on CT indicates the fracture producing force vector: a biomechanical rationale. Internet J Spine Surg 2005;1(2).

  52. Farfan HF, Osteria V, Lamy C. The mechanical etiology of spondylolysis and spondylolisthesis. Clin Orthop 1976;117:40–55.

    PubMed  Google Scholar 

  53. Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O’Brien M. The importance of spino-pelvic balance in L5-S1 developmental spondylolisthesis: a review of pertinent radiologic measurement. Spine (Phila Pa 1976) 2005;30(suppl 6):S27–S34.

    Google Scholar 

  54. Labelle H, Roussouly P, Berthonnaud E, Transfeldt E, O’Brien M, Chopin D, et al. Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study. Spine (Phila Pa 1976) 2004;29:2049–2054.

    Google Scholar 

  55. Terai T, Sairyo K, Goel VK, Ebraheim N, Biyani A, Faizan A, et al. Tensile stress at the ventral aspect of the pars interarticularis causes the initial defect of the pediatric lumbar spondylolysis. 38th annual meeting of the Japanese Society for Spine Surgery and Related Research. J Bone Joint Surg Br 2009;20:390 (in Japanese) (in press).

    Google Scholar 

  56. Wiltse LL. The etiology of spondylolisthesis. J Bone Joint Surg Am 1962;44:539–560.

    PubMed  Google Scholar 

  57. Sairyo K, Katoh S, Sakamaki T, Komatsubara S, Endo K, Yasui N. Three successive stress fractures at the same level in an adolescent baseball player. Am J Sports Med 2003;31:606–610.

    PubMed  Google Scholar 

  58. Iwamoto J, Abe H, Tsukimura Y, Wakano K. Relationship between radiographic abnormalities of lumbar spine and incidence of low back pain in high school rugby players: a prospective study. Scand J Med Sci Sports 2005;15:163–168.

    Article  CAS  PubMed  Google Scholar 

  59. Kono S, Hayashi N, Kasahara T, Akimoto T, Kaneko F, Sugiura Y, et al. A study on the etiology of spondylolysis with reference to athletic activities. J Jpn Orthop Assoc 1975;49:125–133 (in Japanese).

    Google Scholar 

  60. Ohba S, Minami K, Ito H. Incidence, diagnosis and treatment of lumbar spondylolysis in children and adolescents (stress fracture in lumbar spine). Hone Kansetsu Jintai (Bone Joint Ligament) 2006;19:283–293 (in Japanese).

    Google Scholar 

  61. Miyamoto M, Ishimaru A, Baito C, Nashiki H. Clinical and radiological surveys of lumbar spondylolysis in young soccer players in Asahikawa city. Hokkaido Seikeigeka Gaggai Zasshi 1994;37:67–70 (in Japanese).

    Google Scholar 

  62. Kyo M, Kitano K, Tajima K, Miyawaki Y, Nishiura M, Kuwano Y, et al. Medical check of professional soccer team. Seikeigeka (Orthopaedics) 1995;46:243–247 (in Japanese).

    Google Scholar 

  63. Matsumoto M. Conservative treatment of lumbar disorders. Rinshou Sports Igaku (Clinical Sports Medicine) 2006;23:1301–1309 (in Japanese).

    Google Scholar 

  64. Hasegawa A, Kawakami T, Takemasa R, Yamamoto H, Muto Y. Medical check of lumbar spine in baseball players in the national high school baseball championship. Rinshou Sports Igaku (Clinical Sports Medicine) 2002;19:1431–1436 (in Japanese).

    Google Scholar 

  65. Wakitani S, Ochi T, Hirooka J, Yoneda M, Ono K. The study about lumbar spondylolysis found in professional baseball players. Chubu Nihon Seikeigeka Saigaigeka Gakkai Zasshi (Cent Jpn J Orthop Traumatol) 1988;31:538–540 (in Japanese).

    Google Scholar 

  66. Abe H, Shibata H, Bun H, Nakanishi Y, Fukui Y, Yamada H. Spondylolysis in rugby and American football players. Jpn J Orthop Sports Med 1990;9:109–114 (in Japanese).

    Google Scholar 

  67. Kuroki T, Tajima N, Higuchi J. Lumbar disorders of judo players. Jpn J Orthop Sports Med 1994;14:387–390 (in Japanese).

    Google Scholar 

  68. Suzuki K, Funakoshi M, Haneba H. Medical check of lumbar spine in adolescent ice hockey players. Rinshou Sports Igaku (Clinical Sports Medicine) 2002;19:1425–1430 (in Japanese).

    Google Scholar 

  69. Nakagawa Y. Medical check of lumbar spine in college student sumo players. Rinshou Sports Igaku (Clinical Sports Medicine) 2002;19:1445–1449 (in Japanese).

    Google Scholar 

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Sakai, T., Sairyo, K., Suzue, N. et al. Incidence and etiology of lumbar spondylolysis: review of the literature. J Orthop Sci 15, 281–288 (2010). https://doi.org/10.1007/s00776-010-1454-4

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