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Introduction <p>The impact of spondylolysis and isthmic spondylolisthesis on intervertebral disc health in pediatric patients remains poorly understood. The purpose of this study was to characterize intervertebral disc degeneration in pediatric patients with spondylolysis and spondylolisthesis.</p> Methods <p>This was a single-center retrospective cohort study. Patients were included if they were 1) under 18&#xa0;years of age, 2) diagnosed with lumbar spondylolysis or isthmic spondylolisthesis based on computed tomography imaging, and 3) had magnetic resonance imaging of the lumbar spine with T2 sequence. Disc degeneration was graded using the Pfirrmann grading system at the level of the spondylolysis/listhesis. Disc degeneration at L4/5 and L5/S1 was graded in a control patient population of pediatric patients that received an abdominal MRI with a T2 sequence. Disc degeneration was reported as proportions within 4 groups: 1) patients with spondylolysis, 2) patients with grade 1 spondylolisthesis, 3) patients with grade 2–4 spondylolisthesis, and 4) the control group. Descriptive statistics, Chi-square test, and multivariable logistic regression analysis was used for analysis.</p> Results <p>A total of 87 patients were included in this study. There were 67 patients with spondylolysis or spondylolisthesis with a mean age of 14.9 ± 1.9&#xa0;years and 49.3% (n = 33) were female. 62.7% (n = 42) had isolated spondylolysis, 20.9% (n = 14) had grade 1 spondylolisthesis, and 16.5% (n = 11) had grade 2–4 spondylolisthesis. There were 20 control patients with a mean age of 14.7 ± 2.1&#xa0;years and 50.0% (n = 10) were female. In the control population, at 40 intervertebral discs, there was no disc degeneration in 92.5% (n = 37/40) and disc degeneration in 7.5% (n = 3/40). Compared to the control group, patients with spondylolysis (p = 0.04), grade 1 spondylolisthesis (p &lt; 0.001), and grade 2–4 spondylolisthesis (p &lt; 0.001) had higher rates of disc degeneration. The rates of disc degeneration at the level of the pathology for patients with spondylolysis, grade 1 spondylolisthesis, and grade 2–4 spondylolisthesis were 23.8%, 64.3%, and 100.0%, respectively. In the multivariable logistic regression analysis, presence of spondylolysis (OR 4.06, p = 0.04) and spondylolisthesis (OR 49.2, p &lt; 0.001) were associated with higher odds of disc degeneration. Age was not associated with odds of disc degeneration (p = 0.652).</p> Conclusion <p>Intervertebral disc degeneration is common at the level of pathology in pediatric patients with lumbar spondylolysis and spondylolisthesis, with increasing severity of disc degeneration associated with increasing spondylolisthesis.</p>

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Spondylolysis and spondylolisthesis is associated with disc degeneration in pediatric patients

  • 期刊论文

  • 发表日期：

    2026年3月11日

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  • Vivien Chan,
  • Muhammad Mukarram,
  • Kenneth D. Illingworth,
  • David L. Skaggs

摘要

Introduction

The impact of spondylolysis and isthmic spondylolisthesis on intervertebral disc health in pediatric patients remains poorly understood. The purpose of this study was to characterize intervertebral disc degeneration in pediatric patients with spondylolysis and spondylolisthesis.

Methods

This was a single-center retrospective cohort study. Patients were included if they were 1) under 18 years of age, 2) diagnosed with lumbar spondylolysis or isthmic spondylolisthesis based on computed tomography imaging, and 3) had magnetic resonance imaging of the lumbar spine with T2 sequence. Disc degeneration was graded using the Pfirrmann grading system at the level of the spondylolysis/listhesis. Disc degeneration at L4/5 and L5/S1 was graded in a control patient population of pediatric patients that received an abdominal MRI with a T2 sequence. Disc degeneration was reported as proportions within 4 groups: 1) patients with spondylolysis, 2) patients with grade 1 spondylolisthesis, 3) patients with grade 2–4 spondylolisthesis, and 4) the control group. Descriptive statistics, Chi-square test, and multivariable logistic regression analysis was used for analysis.

Results

A total of 87 patients were included in this study. There were 67 patients with spondylolysis or spondylolisthesis with a mean age of 14.9 ± 1.9 years and 49.3% (n = 33) were female. 62.7% (n = 42) had isolated spondylolysis, 20.9% (n = 14) had grade 1 spondylolisthesis, and 16.5% (n = 11) had grade 2–4 spondylolisthesis. There were 20 control patients with a mean age of 14.7 ± 2.1 years and 50.0% (n = 10) were female. In the control population, at 40 intervertebral discs, there was no disc degeneration in 92.5% (n = 37/40) and disc degeneration in 7.5% (n = 3/40). Compared to the control group, patients with spondylolysis (p = 0.04), grade 1 spondylolisthesis (p < 0.001), and grade 2–4 spondylolisthesis (p < 0.001) had higher rates of disc degeneration. The rates of disc degeneration at the level of the pathology for patients with spondylolysis, grade 1 spondylolisthesis, and grade 2–4 spondylolisthesis were 23.8%, 64.3%, and 100.0%, respectively. In the multivariable logistic regression analysis, presence of spondylolysis (OR 4.06, p = 0.04) and spondylolisthesis (OR 49.2, p < 0.001) were associated with higher odds of disc degeneration. Age was not associated with odds of disc degeneration (p = 0.652).

Conclusion

Intervertebral disc degeneration is common at the level of pathology in pediatric patients with lumbar spondylolysis and spondylolisthesis, with increasing severity of disc degeneration associated with increasing spondylolisthesis.