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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 3, 356-359.
doi: 10.1302/0301-620X.90B3.19606  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Degenerative lumbosacral spondylolisthesis

POSSIBLE FACTORS WHICH PREDISPOSE THE FIFTH LUMBAR VERTEBRA TO SLIP

H. Hosoe, BSSC, Senior Physiotherapist1; and K. Ohmori, MD, PhD, ex-Chairman2

1 Department of Rehabilitation Medicine
2 Department of Orthopedic and Spinal Surgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya 466-8650, Japan.

Correspondence should be sent to Mr H. Hosoe; e-mail: hhosoe{at}nagoya2.jrc.or.jp

We have analysed a number of radiological measurements in an attempt to clarify the predisposing factors for degenerative spondylolisthesis of the lumbosacral junction. We identified 57 patients with a slip and a control group of 293 patients without any radiological abnormality apart from age-related changes. The relative thickness of the L5 transverse process, the sacral table angle and the height of the iliac crest were measured and evaluated. The difference in these measurements between men and women was analysed in the control group.

We found that the transverse process of L5 was extremely slender, the sacral table more inclined, and the L5 vertebra was less deeply placed in the pelvis in patients with a slip compared with the control group. The differences in these three parameters were statistically significant.

We believe that the L5 vertebra is predisposed to slip when these factors act together on a rigidly-stabilised sacrum. This occurs more commonly in women, probably as a result of constitutional differences in the development of the male and female spine.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General