title: Association between spondylolisthesis and L5 fracture in patients with Osteogenesis Imperfecta.
abstract: To investigate if an association between spondylolisthesis and L5 fracture occurs in patients affected by Osteogenesis Imperfecta (O.I.).
  
  
  
  Anteroposterior and lateral radiograms were performed on the sample (38 O.I. patients, of whom 19 presenting listhesis); on imaging studies spondylolisthesis was quantified according to the Meyerding classification. Genant's semiquantitative classification was applied on lateral view to evaluate the L5 fractures; skeleton spinal morphometry (MXA) was carried out on the same images to collect quantitative data comparable and superimposable to Genant's classification. The gathered information were analyzed through statistical tests (O.R., χ2test, Fisher's test, Pearson's correlation coefficient).
  
  
  
  The prevalence of L5 fractures is 73.7 % in O.I. patients with spondylolisthesis and their risk of experiencing such a fracture is twice than O.I. patients without listhesis (OR 2.04). Pearson's χ2test demonstrates an association between L5 spondylolisthesis and L5 fracture, especially with moderate, posterior fractures (p = 0.017) and primarily in patients affected by type IV O.I.
  
  
  
  Spondylolisthesis represents a risk factor for the development of more severe and biconcave/posterior type fractures of L5 in patients suffering from O.I., especially in type IV. This fits the hypothesis that the anterior sliding of the soma of L5 alters the dynamics of action of the load forces, localizing them on the central and posterior heights that become the focus of the stress due to movement of flexion-extension and twisting of the spine. As a result, there is greater probability of developing an important subsidence of the central and posterior walls of the soma.
authors.affiliation: Universitary Department of Anatomic, Histologic, Forensic and Locomotor Apparatus Sciences, Section of Locomotor Apparatus Sciences, Policlinico Umberto I, Sapienza University of Rome, Piazzale Aldo Moro 5, 00162, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Persiani
authors.affiliation: Universitary Department of Anatomic, Histologic, Forensic and Locomotor Apparatus Sciences, Section of Locomotor Apparatus Sciences, Policlinico Umberto I, Sapienza University of Rome, Piazzale Aldo Moro 5, 00162, Rome, Italy. jolegraci@yahoo.it.
authors.forename: Jole
authors.initials: J
authors.lastname: Graci
authors.affiliation: Universitary Department of Anatomic, Histologic, Forensic and Locomotor Apparatus Sciences, Section of Locomotor Apparatus Sciences, Policlinico Umberto I, Sapienza University of Rome, Piazzale Aldo Moro 5, 00162, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: de Cristo
authors.affiliation: Universitary Department of Anatomic, Histologic, Forensic and Locomotor Apparatus Sciences, Section of Locomotor Apparatus Sciences, Policlinico Umberto I, Sapienza University of Rome, Piazzale Aldo Moro 5, 00162, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Noia
authors.affiliation: Universitary Department of Anatomic, Histologic, Forensic and Locomotor Apparatus Sciences, Section of Locomotor Apparatus Sciences, Policlinico Umberto I, Sapienza University of Rome, Piazzale Aldo Moro 5, 00162, Rome, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Villani
authors.affiliation: Universitary Department of Pediatrics, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Celli
mesh_terms: D015331:Cohort Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D010013:Osteogenesis Imperfecta / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology; D013168:Spondylolisthesis / Q000150:complications / Q000453:epidemiology
keywords: Children; Osteogenesis Imperfecta; Spine; Spondylolisthesis; Vertebral fracture