title: The incidence of spondylolysis and spondylolisthesis in children with osteogenesis imperfecta.
abstract: BACKGROUND
  Spondylolysis and spondylolisthesis are common abnormalities of the lumbar spine. The incidence of these diagnoses is recognized in the healthy population. However, their incidence in osteogenesis imperfecta (OI) patients is less well defined.
  
  
  METHODS
  This is a retrospective radiographic review of patients treated in the OI clinic from a single institution. Lateral radiographs were reviewed on all available patients to assess the incidence of spondylolysis and spondylolisthesis in this patient population. The morphology of the pedicle and pars interarticularis was also evaluated to identify any abnormalities or dysplasia of these structures.
  
  
  RESULTS
  One hundred ten of the 139 patients treated in the OI clinic met the inclusion criteria for this study. Of these patients, 79% (87 of 110) were ambulatory. The overall incidence of spondylolysis in this pediatric OI population was found to be 8.2% (9 of 110) at an average age of 7.5 years. The incidence of spondylolisthesis was 10.9% (12 of 110) at an average age of 6.5 years with 75% (3 of 12) being isthmic type and 25% (3 of 12) dysplastic. The combined incidence of spondylolysis and spondylolisthesis was 19.2%. Incidentally, the pedicle length was noted to be elongated in 40.0% (44 of 110) of this OI population.
  
  
  CONCLUSIONS
  This study found that the incidence of spondylolysis in a group of children with OI was much higher than in the normal pediatric population, which has been reported to be 2.6% to 4.0%. This incidence was also found to be higher than previously reported incidence of spondylolysis in OI patients (5.3%). The incidence of spondylolisthesis was also found to be much higher than that of the normal pediatric population (4.2%). It is important to recognize this higher incidence of these abnormalities and to anticipate future associated symptoms and potential worsening listhesis that can clinically affect the lifestyles of these children and potentially require surgical treatment. The clinical significance of these findings will necessitate long-term follow-up.
authors.affiliation: University of Nebraska Medical Center Children's Hospital and Medical Center, Omaha, NE 68114, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hatz
authors.forename: Paul W
authors.initials: PW
authors.lastname: Esposito
authors.forename: Bruce
authors.initials: B
authors.lastname: Schroeder
authors.forename: Bridget
authors.initials: B
authors.lastname: Burke
authors.forename: Richard
authors.initials: R
authors.lastname: Lutz
authors.forename: Brian P
authors.initials: BP
authors.lastname: Hasley
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010013:Osteogenesis Imperfecta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011859:Radiography; D012189:Retrospective Studies; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D013169:Spondylolysis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology