A morphological characterization of the lumbar neural arch in females and males with degenerative spondylolisthesis

Saher Abu-Leil; Asaf Weisman; Yizhar Floman; Fabio Galbusera; Youssef Masharawi

doi:10.1186/s12891-021-04901-6

A morphological characterization of the lumbar neural arch in females and males with degenerative spondylolisthesis

BMC Musculoskelet Disord. 2021 Dec 8;22(1):1026. doi: 10.1186/s12891-021-04901-6.

Authors

Saher Abu-Leil¹, Asaf Weisman¹, Yizhar Floman², Fabio Galbusera³, Youssef Masharawi⁴

Affiliations

¹ The Spinal Research Laboratory, Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, 69978, Tel Aviv, Ramat Aviv, Israel.
² Israel Spine Center, Assuta Hospital, Tel-Aviv, Israel.
³ Istituto Ortopedico Galeazzi, Milan, Italy.
⁴ The Spinal Research Laboratory, Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, 69978, Tel Aviv, Ramat Aviv, Israel. yossefm@post.tau.ac.il.

Abstract

Background: Although Degenerative Spondylolisthesis (DS) is a common osseous dysfunction, very few studies have examined the bony morphology of lumbar the neural arch in the population afflicted with DS. Therefore, this study aimed to characterize the neural arch (NA) morphology along the entire lumbar spine in individuals with degenerative spondylolisthesis (DS) and compare them to healthy controls.

Methods: One hundred CTs from a database of 500 lumbar CTs of spondylolisthesis were selected. We excluded vertebral fractures, non-L4-L5 slips, previous surgeries, vertebral spondyloarthropathies, and scoliosis. Scans were divided into a study group of 50 individuals with single-level DS (grades 1-2) at L4-5 (25 males and 25 females), and an age-sex matched control group of 50 individuals. Linear and angular measurements from all lumbar segments included: vertebral canals, intervertebral foramens, pedicles, and articular facets.

Results: Compared with the controls, all individuals with DS had greater pedicle dimensions in the lower lumbar segments (∆ = 1 mm-2.14 mm) and shorter intervertebral foramens in all the lumbar segments (∆range:1.85 mm-3.94 mm). In DS females, the lower lumbar facets were mostly wider (∆ = 1.73-2.86 mm) and more sagittally-oriented (∆10°) than the controls. Greater prevalence of grade-3 facet arthrosis was found only in the DS population (DS = 40-90%,controls = 16.7-66.7%). In DS males, degenerated facets were observed along the entire lumbar spine (L1-S1), whereas, in DS females, the facets were observed mainly in the lower lumbar segments (L4-S1). Individuals with DS have shorter intervertebral foramens and greater pedicle dimensions compared with controls.

Conclusions: Females with DS have wider articular facets, more sagittally-oriented facets, and excessively degenerated facets than the controls. This unique NA shape may further clarify DS's pathophysiology and explain its greater prevalence in females compared to males.

Keywords: Degenerative Spondylolisthesis; Facet arthrosis; Morphometry; Neural arch; Spondylolisthesis.

MeSH terms

Female
Foot
Humans
Lumbar Vertebrae / diagnostic imaging
Lumbosacral Region
Male
Scoliosis*
Spondylolisthesis* / diagnostic imaging
Spondylolisthesis* / epidemiology