title: Lumbar Spondylolysis and Spondylolisthesis in Down Syndrome: A Cross-sectional Study at One Institution.
abstract: METHODS
  Retrospective cross-sectional study.
  
  
  OBJECTIVE
  To describe lumbar spondylolysis and spondylolisthesis and establish their prevalence in individuals with Down syndrome.
  
  
  BACKGROUND
  Orthopedic problems in Down syndrome are variable and numerous. Lumbar spondylolysis and spondylolisthesis may be common conditions in Down syndrome. However, there has been a paucity of data on the association of these conditions in the published literature.
  
  
  METHODS
  A retrospective review of 110 patients with Down syndrome seen at a single institution from 2000 through 2012 was performed. Medical records, X-rays, and physician dictations were carefully reviewed to establish a detailed database of the study population.
  
  
  RESULTS
  Of the 110 patients in the study, 20 exhibited spondylolysis (unilateral, n = 11; bilateral, n = 9), whereas 38 had lumbar spondylolisthesis (isthmic, n = 9; dysplastic, n = 2; degenerative, n = 27). No gender difference was noted (p ≥ .7732). Fifteen patients reported low back pain (LBP) and/or leg pain. There was no significant association between LBP, leg pain, and spondylolysis (p = .9232). Both of these symptoms were highly predictive of lumbar spondylolisthesis, however (p = .0006). No significant findings were noted in pelvic parameters (pelvic incidence, sacral slope, pelvic tilt, or lumbar lordosis) in this study.
  
  
  CONCLUSIONS
  The prevalence of spondylolysis and spondylolisthesis in individuals with Down syndrome may be as high as 18.7% and 32.7%, respectively, significantly higher than in the non-Downs population. Etiopathogenesis of these conditions in Down syndrome does not appear to be related to pelvic parameters. Low back pain and leg pain may be more predictive of spondylolisthesis in Down syndrome than in the general population. Therefore, it is recommended that individuals with Down syndrome and LBP and/or leg pain be evaluated for lumbar spondylolisthesis.
authors.affiliation: Illinois Bone and Joint Institute, 9000 Waukegan Road, Morton Grove, IL 60053, USA. Electronic address: mark.hansdorfer@gmail.com.
authors.forename: Marek A
authors.initials: MA
authors.lastname: Hansdorfer
authors.affiliation: Illinois Bone and Joint Institute, 9000 Waukegan Road, Morton Grove, IL 60053, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Mardjetko
authors.affiliation: College of Health Professions, Rosalind Franklin University, 3333 Green Bay Road, North Chicago, IL 60064, USA.
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Knott
authors.affiliation: Illinois Bone and Joint Institute, 9000 Waukegan Road, Morton Grove, IL 60053, USA.
authors.forename: Samantha E
authors.initials: SE
authors.lastname: Thompson
keywords: Down syndrome; Low back pain; Spondylolisthesis; Spondylolysis