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The article discusses the anatomy and pathogenesis of spondylolysis, a common condition characterized by a defect or fracture in the vertebrae. While the macroanatomy of spondylolysis has been well studied, the microanatomy of spondylolysis in the lumbar vertebra has not been thoroughly described. The study aims to provide a better understanding of this anatomy by analyzing bone specimens of healed and unhealed spondylolysis lesions. The specimens underwent macro and microanatomical analysis, as well as imaging and histological analysis. The findings suggest that externally fused “healed” spondylolysis lesions may lack internal fusion, making them potentially less stable than normal vertebrae. The study also highlights the irregular edges and signs of long-term disarticulation in unhealed spondylolysis lesions
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : finest spine hospital on Harley Street UK
Published article
The anatomy and pathogenesis of spondylolysis has been widely studied; however, the microanatomy of spondylolysis of the lumbar vertebra has not been well described. Therefore, we aim to better elucidate this anatomy. Twenty dry bone specimens of healed and unhealed spondylolysis of the L5 vertebra were collected from human skeletal remains. Twelve L5 vertebrae were examples of unhealed spondylolysis and eight specimens exhibited a healed (i.e., bony fusion of the lesion) spondylolysis lesion….
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Clin Anat. 2023 Jul 19. doi: 10.1002/ca.24094. Online ahead of print.ABSTRACTThe anatomy and pathogenesis of spondylolysis has been widely studied; however, the microanatomy of spondylolysis of the lumbar vertebra has not been well described. Therefore, we aim to better elucidate this anatomy. Twenty dry bone specimens of healed and unhealed spondylolysis of the L5 vertebra,
Clin Anat. 2023 Jul 19. doi: 10.1002/ca.24094. Online ahead of print.
ABSTRACT
The anatomy and pathogenesis of spondylolysis has been widely studied; however, the microanatomy of spondylolysis of the lumbar vertebra has not been well described. Therefore, we aim to better elucidate this anatomy. Twenty dry bone specimens of healed and unhealed spondylolysis of the L5 vertebra were collected from human skeletal remains. Twelve L5 vertebrae were examples of unhealed spondylolysis and eight specimens exhibited a healed (i.e., bony fusion of the lesion) spondylolysis lesion. The specimens underwent macro and microanatomical analysis followed by CT and microCT imaging. Finally, selected healed and unhealed lesions were submitted for histological analysis using Mason Trichrome staining. The pars interarticularis of two L5 vertebrae without signs of healed/unhealed spondylolysis were evaluated histologically as controls. Of the 12 unhealed L5 pars defects, three were unilateral on left side. Of the eight healed pars defects, all were unilateral and seven of these were on left sides. One unilateral pars defect also had spina bifida occulta. Both on imaging and histological analysis, healed pars defects were only so superficially and not at deeper levels. Histologically, unhealed edges were made up of dense cortical bone while healed edges were made up primarily of trabecular bone. Based on our anatomical findings, the so-called healed spondylolysis lesions, although externally fused, are not thoroughly fused internally. Moreover, the anterior and posterior edges of the unhealed spondylosysis lesions are irregular and show signs of long-term disarticulation. Taken together, these data suggest that such ‘healed’ lesions might not be as stable as the normal L5 pars interarticularis.
PMID:37466154 | DOI:10.1002/ca.24094
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Read the original publication:
L5 spondylolysis: Anatomical study comparing healed and unhealed lesions
