Summary
A clinical and radiological follow-up investigation with at least 20 years observation time was made of 255 persons with lumbar spondylolysis with or without spondylolisthesis. The main purposes were to study the relationship between clinical and radiological features and to look for radiological and other variables of prognostic value. There was a clear positive correlation of symptoms and functional impairment during the observation period to disc degeneration and vertebral slipping at follow-up, as well as to a decrease in lumbar index at the time of diagnosis. Individual factors and radiological signs at the time of diagnosis were shown to have prognostic value for the course of the disease. The risk factors for severe symptoms and need for treatment were more than 10 mm of vertebral slipping, low lumbar index, increased lumbar lordosis, lysis in the fourth lumbar vertebra and early onset of symptoms.
Résumé
Un bilan clinique et radiologique a été effectué après un délai d'observation d'au moins 20 ans chez 255 sujets porteurs d'une spondylolyse lombaire, avec ou sans spondylolisthésis. Le but de cette étude était d'évaleur les relations entre les données cliniques et radiologiques et de rechercher quels éléments, radiologiques ou autres, pouvaient avoir une valeur pronostique dès le début de l'affection. On a pu mettre en évidence une corrélation significative entre d'une part la symptomatologie et le handicap fonctionnel durant la période d'observation et, d'autre part, l'importance du glissement et de la dégénérescence discale au moment de la révision, de même que la diminution de l'index lombaire au moment du diagnostic initial. Les facteurs individuels et les signes radiologiques notés à ce moment permettent également d'établir un pronostic. Les facteurs qui sont en faveur d'une symptomatologie sévère et de la nécessité d'un traitement sont les suivants: un glissement de plus de 10 mm, un faible index lombaire, une hyperlordose lombaire, une lyse de la 4ème vertèbre lombaire et un début précoce des symptômes.
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References
Gavatin A, Eklund G (1972) Automatic Interaction Detector (AID) analysis. Scand J Inf Dis Suppl 3: 89–91
Gyntelberg F (1974) One year incidence of low-back pain among male residents of Copenhagen aged 40–59. Dan Med Bull 21: 30–36
Helander E (1973) Back pain and work disability. Soc Med T 50: 398
Horal J (1969) The clinical appearance of low-back disorders in the city of Gothenburg, Sweden. Acta Orthop Scand Suppl 118
Hult L (1954b) Cervical, dorsal and lumbar spinal syndromes. Acta Orthop Scand Suppl 17
Hussar AE, Guller EJ (1956) Correlation of pain and the roentgenographic findings of spondylolosis of the cervical and lumbar spine. Am J Med Sci 232: 518–527
Jackson DW, Wiltse LL, Dingeman RD, Hayes M (1981) Stress reactions involving the pars interarticularis in young athlets. Am J Sports Med 9: 304–312
Lemaire JP, Grammont P (1981) Dynamique du spondylolisthesis isthmique et stratégie chirurgicale. Acta Orthop Belg 47: 458–463
Libson E, Bloom RA, Dinari G (1982) Symptomatic and asymptomatic spondylolysis and spondylolisthesis in young adults. Int Orthop 6: 259–261
Maldague B, Malghem J (1981) Aspects radiologiques dynamiques de la spondylolyse lombaire. Acta Orthop Belg 47: 441–457
Saraste H, Broström L-Å, Aparisi T (1983) Radiographic assessement of anatomical deviations in lumbar spondylolysis. (Submitted)
Saraste H, Broström L-Å, Aparisi T (1983) Vertebral slipping and disc degeneration in spondylolysis — prognosticradiographic aspects. (Submitted)
Splithoff A (1953) Lumbosacral junction, Roentgenographic comparison of patients with and without backaches. JAMA 152: 1610–1613
Taillard WF (1974) Etiology of spondylolisthesis. Clin Orthop Res 117: 30
Wiltse LL, Widell EH, Jackson DW (1975) Fatique fracture: The basic lesion in isthmic spondylolisthesis. J Bone Joint Surg 57A: 17–22
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Saraste, H., Nilsson, B., Broström, LÅ. et al. Relationship between radiological and clinical variables in spondylolysis. International Orthopaedics 8, 163–174 (1984). https://doi.org/10.1007/BF00269912
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DOI: https://doi.org/10.1007/BF00269912