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L5 Pedicle Length Is Increased in Subjects With Spondylolysis: An Anatomic Study of 1072 Cadavers

  • Basic Research
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Clinical Orthopaedics and Related Research®

Abstract

Background

In spondylolisthesis, it is believed that as L5 slips on S1, the pedicle may become elongated in response to the instability in an attempt to bridge the defect. Whether patients with spondylolysis, which is largely developmental, also develop elongation of the pedicles is unknown.

Questions/purposes

The purpose of this study is to evaluate and quantify the increase in L5 pedicle length in subjects with spondylolysis as compared with normal healthy subjects.

Methods

Nine hundred fifty-two human cadaveric specimens without spondylolysis and 120 specimens with spondylolysis from the Hamann-Todd Osteological Collection were examined by a single examiner. Baseline data, including age, sex, and race of specimens, were collected. Digital calipers were used to measure the pedicle lengths at the L5 level. Linear regression analysis was performed to compare the L5 pedicle lengths in healthy patients and patients with spondylolysis.

Results

Linear regression showed a significant association of increased L5 pedicle length in subjects with spondylolysis. The average L5 pedicle length in subjects with spondylolysis was greater compared with subjects without spondylolysis. In spondylolytic specimens, pedicles start to elongate after the age of 40 years. The pedicle lengths increase progressively from 5.6 mm at 40 years to 6.7 mm at 80 years with a 1% to 3% increment every decade. The pedicle lengths showed little variation in specimens from healthy subjects.

Conclusions

In spondylolytic specimens, there is progressive elongation of L5 pedicle length after the third decade. An increase in L5 pedicle length in all age groups compared with the specimens from healthy subjects suggests that pathologic changes occur in bony anatomy of L5 vertebrae as early as adolescence when the condition develops.

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Authors and Affiliations

  1. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Navkirat S. Bajwa BS

  2. Department of Orthopaedics & Rehabilitation, Yale School of Medicine, New Haven, CT, USA

    Jason O. Toy MD

  3. Department of Orthopaedics, Case Western Reserve University, University Hospitals, Cleveland, OH, USA

    Nicholas U. Ahn MD

  4. 13612 Silver Road, Garfield Heights, OH, 44125, USA

    Navkirat S. Bajwa BS

Authors
  1. Navkirat S. Bajwa BS
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  2. Jason O. Toy MD
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  3. Nicholas U. Ahn MD
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Corresponding author

Correspondence to Navkirat S. Bajwa BS.

Additional information

Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Case Western School of Medicine, Department of Orthopaedics, Cleveland, OH, USA.

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Bajwa, N.S., Toy, J.O. & Ahn, N.U. L5 Pedicle Length Is Increased in Subjects With Spondylolysis: An Anatomic Study of 1072 Cadavers. Clin Orthop Relat Res 470, 3202–3206 (2012). https://doi.org/10.1007/s11999-012-2439-8

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  • DOI: https://doi.org/10.1007/s11999-012-2439-8

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