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
Wiltse LL, Widell EH Jr, Jackson DW. Fatigue fracture: the basic lesion in isthmic spondylolisthesis. J Bone Joint Surg Am 1975;57:17–22.
Hasebe K. Die Wirbelsaule der Japaner. Z Morphol Anthropol 1913;15:259–380.
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).
Suzuki T. Indicators of stress in prehistoric Jomon skeletal remains in Japan. Anthropol Sci 1998;106(suppl):127–137.
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.
Eisenstein S. Spondylolysis: a skeletal investigation of two population groups. J Bone Joint Surg Br 1978;60:488–494.
Arriaza BT. Spondylolysis in prehistoric human remains from Guam and its possible etiology. Am J Phys Anthropol 1997;104:393–397.
Gunness-Hey M. The Koniag Eskimo presacral vertebral column: variations, anomalies and pathologies. OSSA 1980;7:99–118.
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.
Merbs CF. Patterns of activity-induced pathology in a Canadian Inuit population. Archaeol Surv Canada 1983;119:120–128.
Stewart TD. Incidence of separate neural arch in the lumbar vertebrae of Eskimos. Am J Phys Anthropol 1931;16:51–62.
Simper LB. Spondylolysis in Eskimo skeletons. Acta Orthop Scand 1986;57:78–80.
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).
Ogata N, Fujita M, Yamamoto S. Epidemiology of lumbar spondylolysis. MB Orthop 2007:20:1–6 (in Japanese).
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).
Akimoto T. The etiology of spondylolysis with reference to athletic activities during growing period. Seikeigeka (Orthopaedics) 1979;30:638–646 (in Japanese).
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.
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.
Amato M, Totty WG, Gilula LA. Spondylolysis of the lumbar spine: demonstration of defects and laminal fragmentation. Radiology 1984;153:627–629.
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.
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.
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.
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.
Belfi LM, Ortiz AO, Katz DS. Computed tomography evaluation of spondylolysis and spondylolisthesis in asymptomatic patients. Spine (Phila Pa 1976) 2006;31:E907–E910.
Mays S. Spondylolysis, spondylolisthesis, and lumbo-sacral morphology in a medieval English skeletal population. Am J Phys Anthropol 2006;131:352–362.
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.
Burkus JK. Unilateral spondylolysis associated with spina bifida occulta and nerve root compression. Spine (Phila Pa976) 1990;15:555–559.
Bollerslev J, Mosekilde L. Autosomal dominant osteopetrosis. Clin Orthop 1993;294:45–51.
Szappanos L, Szepesi K, Thomázy V. Spondylolysis in osteopetrosis. J Bone Joint Surg Br 1988;70:428–430.
Martin R, Deane R, Collett V. Spondylolysis in children who have osteopetrosis. J Bone Joint Surg Am 1997;79:1685–1689.
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.
Rosenberg NJ, Bargar WL, Friedman B. The incidence of spondylolysis and spondylolisthesis in nonambulatory patients. Spine (Phila Pa 1976) 1981;6:35–38.
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).
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.
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.
Ogilvie JW, Sherman J. Spondylolysis in Scheuermann’s disease. Spine (Phila Pa 1976) 1987;12:251–253.
Greene TL, Hensinger RN, Hunter LY. Back pain and vertebral changes simulating Scheuermann’s disease. J Pediatr Orthop 1985;5:1–7.
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.
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.
Shahriaree H, Sajadi K, Rooholamini SA. A family with spondylolisthesis. J Bone Joint Surg Am 1979;61:1256–1258.
Wynne-Davies R, Scott JH. Inheritance and spondylolisthesis: a radiographic family survey. J Bone Joint Surg Br 1979;61:301–305.
Albanese M, Pizzutillo PD. Family study of spondylolysis and spondylolisthesis. J Pediatr Orthop 1982;2:496–499.
Rowe GG, Roche MB. The etiology of separate neural arch. J Bone Joint Surg Am 1953;35:102–110.
Kaneko F. Studies on the relation between spondylolysis and developmental anatomies of lumbosacral region. J Jpn Orthop Assoc 1977;51:1237–1253 (in Japanese).
Jackson DW, Wiltse LL, Cirincoine RJ. Spondylolysis in the female gymnast. Clin Orthop 1976;117:68–73.
Semon RL, Spengler D. Significance of lumbar spondylolysis in college football players. Spine (Phila Pa 1976) 1981;6:172–174.
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.
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.
Soler T, Calderon C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med 2000;28:57–62.
Teitz CC. Sports medicine concerns in dance and gymnastics. Pediatr Clin North Am 1982;29:1399–1421.
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).
Farfan HF, Osteria V, Lamy C. The mechanical etiology of spondylolysis and spondylolisthesis. Clin Orthop 1976;117:40–55.
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.
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.
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).
Wiltse LL. The etiology of spondylolisthesis. J Bone Joint Surg Am 1962;44:539–560.
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.
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.
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).
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).
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).
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).
Matsumoto M. Conservative treatment of lumbar disorders. Rinshou Sports Igaku (Clinical Sports Medicine) 2006;23:1301–1309 (in Japanese).
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).
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).
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).
Kuroki T, Tajima N, Higuchi J. Lumbar disorders of judo players. Jpn J Orthop Sports Med 1994;14:387–390 (in Japanese).
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).
Nakagawa Y. Medical check of lumbar spine in college student sumo players. Rinshou Sports Igaku (Clinical Sports Medicine) 2002;19:1445–1449 (in Japanese).
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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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DOI: https://doi.org/10.1007/s00776-010-1454-4