Adolescent ; Female ; Humans ; Sacrum ; pathology ; surgery ; Spondylolysis ; diagnosis ; pathology ; surgery

OBJECTIVES: To expound the injury-disease relationship between spondylolysis and trauma for the points of forensic identification. METHODS: Total 26 cases of spondylolysis were collected and the characteristics of this disease such as age, accompanied symptoms, treatment and injury manner were discussed. RESULTS: The causal relationship existed between trauma and injury consequence in 2 appraised individuals and both of them aged less than 50 years old. The injury manners of both were high-energy injury with combined injury and these 2 patients were treated by operation. CONCLUSIONS The analysis of injury-disease relationship between spondylolysis and trauma should be paid attention in the middle-young age under 50 years old. More importantly, the injury-disease relationship should be analyzed in the patients who chose operative treatment.
Forensic Pathology ; Humans ; Middle Aged ; Spondylolysis/surgery* ; Wounds and Injuries/surgery*

OBJECTIVES: To explore the casual relationship and the significance of identification among the injury, disease and damage consequence in the disability evaluation of lumbar spondylolysis by the standard for identifying grading of disability caused by work-related injuries. METHODS: The general data, injury manner, clinical treatment and the imaging examination of 32 lumbar spondylolysis cases were collected and retrospectively analyzed. According to the degree of participation in the injury and damage consequence, the identification and assessment of casual relationship was made, and the grading of disability was assessed. RESULTS: For 32 cases, injury had no effect on damage consequence in 7 cases, slight effect in 5 cases, secondary effect in 13 cases, equivalent effect in 4 cases, and complete effect in 3 cases. According to the related items in the standard for identifying grading of disability caused by work-related injuries, 3 cases were rated level 7, 5 cases were level 8, 6 cases were level 9, 11 cases were level 11 among the cases which existed causal relationship. CONCLUSIONS The formation of lumbar spondylolysis is connected to the factors of age, anatomy, occupation and injury manner etc. The degree of disability should be accessed comprehensively after the analysis of the casual relationship among the injury, disease and damage consequence.
Disability Evaluation ; Female ; Humans ; Lumbar Vertebrae/pathology* ; Retrospective Studies ; Spondylolysis/pathology*

STUDY DESIGN: A prospective radiographic study of cervical spine with congenital monosegment fusion. PURPOSE: To evaluate the effect of cervical synostosis on adjacent segments and the vertebral morphology. OVERVIEW OF LITERATURE: There are numerous clinical studies of adjacent segment disease (ASD) after monosegment surgical fusion. However, there was no report on ASD in the cervical spine with congenital monosegment synostosis. METHODS: Radiograms of 52 patients, aged 5 to 90 years, with congenital monosegment synostosis (CMS) between C2 and C6, who complained of neck/shoulder discomfort or pain were studied. 51 were normally aligned and one was kyphotically aligned. RESULTS: Spondylosis was not found in the patients below 35 years of age. Only 12 out of 24 patients with normally aligned C2-3 synostosis had spondylosis in 19 more caudal segments, and only one at C3-4. A patient with kyphotic C2-3 had spondylolysis at C3-4. In 8 patients with C3-4 synostosis, spondylosis was found in only 9 caudal segments (4 at C4-5, 4 at C5-6, and 1 at C6-7). The caudate C4-5 disc was the most liable to degenerate in comparison with other caudate segments. Caudal corporal flaring and inwaisting of the synostotic vertebra were the features that were the most evident. In 2 of 9 C4-5 and 7 out of 10 C5-6 synostosis patients, spondylosis was found at the two adjacent cephalad and caudate segments, respectively. Only corporal inwaisting without flaring was found. In all cases, spondylosis was confined to the adjacent segments. More advanced spondylosis was found in the immediate caudal segment than the cephalad one. CONCLUSIONS: It is concluded that spondylosis at the mobile segments in a synostotic spine is thought to be a fusion-related pathology rather than solely age-related disc degeneration. Those data suggested that CMS definitely precipitated the disc degeneration in the adjacent segments.
Humans ; Intervertebral Disc Degeneration ; Pathology ; Prospective Studies ; Spine* ; Spondylolysis ; Spondylosis ; Synostosis*

BACKGROUNDRecent studies have suggested an association between elevated pelvic incidence (PI) and the development of lumbar spondylolysis. However, there is still lack of investigation for Han Chinese people concerning the normal range of spinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases. The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population.

METHODSA total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force (Beijing, China) were identified as the spondylolysis group. All the 52 patients were divided into two subgroups, Subgroup A: 36 patients with simple lumbar spondylolysis, and Subgroup B: 16 patients with lumbar spondylolysis accompanying with mild lumbar spondylolisthesis (slip percentage <30%). Altogether 207 healthy adults were chosen as the control group. All patients and the control group took lumbosacral lateral radiographs. Seven sagittal lumbosacral parameters, including PI, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), L5 incidence, L5 slope, and sacral table angle (STA), were measured in the lateral radiographs. All the parameters aforementioned were compared between the two subgroups and between the spondylolysis group and the control group with independent-sample t- test.

RESULTSThere were no statistically significant differences of all seven sagittal lumbosacral parameters between Subgroup A and Subgroup B. PI, PT, SS, and LL were higher (P < 0.05) in the spondylolysis group than those in the control group, but STA was lower (P < 0.001) in the spondylolysis group.

CONCLUSIONSCurrent study results suggest that increased PI and decreased STA may play important roles in the pathology of lumbar spondylolysis in Han Chinese population.

Adolescent ; Adult ; China ; Female ; Humans ; Lumbosacral Region ; anatomy & histology ; Male ; Middle Aged ; Radiography ; Spondylolysis ; pathology ; Young Adult

A 24-year-old male patient was initially evaluated for persistent back pain. The visual analogue scale (VAS) score was 7 points. Physical examination revealed a decreased range of lumbar spinal motion, which caused pain. Simple X-ray revealed Meyerding grade 1 spondylolisthesis at L4 on L5, with mild dome-shaped superior endplate and consecutive multilevel spondylolysis at T12-L5. Standing anteroposterior and lateral views of the entire spine revealed normal balance of sagittal and coronal alignment. A computed tomography scan revealed bilateral spondylolysis at T12-L4, left unilateral spondylolysis at L5, and spina bifida at L5 to sacral region. Magnetic resonance imaging revealed mild dural ectasia at the lumbar region. Due to the absence of any neurological symptoms, the patient was managed conservatively. He was rested a few weeks with corset brace and physiotherapy. After treatment, his back pain improved, VAS score changed from 7 to 2, and he was able to return to normal activity.
Adult ; Back Pain/etiology ; Humans ; *Lumbar Vertebrae/pathology/radiography ; Magnetic Resonance Imaging ; Male ; *Spinal Dysraphism ; *Spondylolisthesis/pathology/radiography ; *Spondylolysis/pathology/radiography ; *Thoracic Vertebrae/pathology/radiography ; Young Adult

STUDY DESIGN: Cross-sectional study of healthy volunteers. PURPOSE: We aimed to investigate the variation in the lumbar facet joint orientation in an adult Asian population. The relationship between the facet joint orientation and muscle cross-sectional area (CSA) of multifidus and erector spinae was also clarified. OVERVIEW OF LITERATURE: Several studies have reported that lumbar pathologies, such as lumbar spondylolysis and degenerative spondylolisthesis, were related to the horizontally shaped lumbar facet joint orientation at the lower lumbar level. However, data regarding variations in the facet joint orientation in asymptomatic subjects have not been well documented. METHODS: In 31 healthy male adult Asian volunteers, the facet joint orientation and CSA of multifidus and erector spinae were measured using magnetic resonance imaging at the L4–5 and L5–S1 levels. Variation in the facet joint orientation was examined using coefficients of variation (CV). Pearson's product-moment coefficient was used to investigate the relationship between the facet joint orientation and CSA of multifidus and erector spinae. RESULTS: Lumbar facet joint orientation had a wider range of variation at L5–S1 (CV=0.30) than at L4–5 (CV=0.18). The L4–5 facet joint orientation had a weak but significant correlation with the CSA of erector spinae (r=0.40; p=0.031). The CSA of the multifidus had no relationship with the facet joint orientation at the L4–5 (r=0.19; p=0.314) and the L5–S1 level (r=0.19; p=0.312). CONCLUSIONS: The lumbar facet joint orientation was found to have a wide variation, particularly at the L5–S1 in the Asian adult population, and the facet joint orientation had a relationship with the CSA of the erector spinae at the L4–5.
Adult* ; Asian Continental Ancestry Group* ; Cross-Sectional Studies ; Healthy Volunteers ; Humans ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Paraspinal Muscles* ; Pathology ; Spondylolisthesis ; Spondylolysis ; Volunteers ; Zygapophyseal Joint*