Pars interartikülaris defekti, spondilolistezis ve pelvik insidans ilişkisi

Abstract

AMAÇ: Pars interartikülaris defekti (PİD) toplumda sık görülen, bel ağrısı ve radikülopati ile seyredebilen bir problemdir. Manyetik rezonans görüntüleme (MRG) yüksek duyarlılıkla saptayabilmektedir. Tedavi edilmediği durumlarda spondilolistezise ilerleyebilir. Bu çalışmada PİD ve spondilolistezis ile pelvik insidans (Pİ) arasındaki ilişkiyi inceleyerek, PİD sonrası spondilolistezis gelişmesini takip etmek açısından Pİ açısının önemini vurgulamak istedik. GEREÇ VE YÖNTEM: Şanlıurfa Eğitim ve Araştırma hastanesine 2021-2022 yılları arasında başvuran ve lomber MRG yapılan 118 hasta çalışmaya dahil edildi. MRG’de pars interartikülaris defekti saptanması, aynı zamanda direk radyografi veya BT ile değerlendirilebiliyor olması, Pİ ölçümü yapılabilecek şekilde femur başı ve sakrumun izlenebilmesi hastaların çalışmaya dahil edilme kriterlerini oluşturdu. BT ile doğrulanarak Pİ açısı ölçümü yapıldı. PİD, spondilolistezis ve Pİ arasındaki ilişki incelendi. BULGULAR: Çalışmaya katılan 118 hastanın 77(%65,3)’si kadın 41(34,7)’i erkekti. Pars defekti en sık L5 seviyesinde görülmüştür (%67,8). Pelvik insidans açısı ortalama 64,2±8,6’dır. Hastaların yarısı Meyerding evre 0 olarak hesaplanmıştır ve %95,8’i medikal olarak tedavi edilmiştir. Spondilolistezis olmayan hastaların pelvik insidans açı ortanca değeri 58,0, Meyerding evrelemesi bir olan hastaların pelvik insidans açı ortanca değeri 68,0, ikinin üzerinde olanların ise 78,0 olarak saptanmıştır (p<0,001) SONUÇ: Biz bu çalışmada MRG ile PİD olan hastaları tespit ederek, yüksek Pİ derecesi ile PİD ve spondilolistezis arasında anlamlı bir ilişki olduğunu ortaya koyduk. PİD saptanan hastalarda yüksek Pİ saptandığında, bu hastalarda spondilolistezis gelişebileceğini öngörmek takip ve tedaviyi şekillendirecek önemli bir bulgudur.

Keywords

• PARS İNTERARTİKÜLARİS DEFEKTİ
• SPONDİLOLİSTEZİS
• PELVİK İNSİDANS

Pelvic incidence effects pars interarticularis defect and spondylolisthesis

Abstract

Aims: Pars interarticularis defect (PID) is a common problem in society and may be accompanied with low back pain and radiculopathy. Magnetic resonance imaging (MRI) can detect it with high sensitivity. If left untreated, it may progress to spondylolisthesis. In this study, we wanted to emphasize the importance of the pelvic incidence (PI) angle in terms of following the development of spondylolisthesis after PID by examining the relationship between PID and spondylolisthesis and PI. Methods: 118 patients who applied to Şanlıurfa Training and Research Hospital between 2021-2022 and underwent lumbar MRI were included in the study. The criteria for inclusion of patients in the study were the detection of a pars interarticularis defect on MRI, the ability to be evaluated by direct radiography or CT, and the ability to monitor the femoral head and sacrum in a way that PI could be measured. PI angle measurement was performed, confirmed by CT. The relationship between PID, spondylolisthesis and PI was examined. Results: Of the 118 patients participating in the study, 77 (65.3%) were women and 41 (34.7%) were men. Pars defect was most commonly seen at the L5 level (67.8%). The average pelvic incidence angle is 64.2±8.6. Half of the patients were calculated as Meyerding grade 0 and 95.8% were treated medically. The median pelvic incidence angle value of patients without spondylolisthesis was found to be 58.0, the median pelvic incidence angle value of patients with a Meyerding grading of one was found to be 68.0, and the median value of the pelvic incidence angle of patients with a Meyerding grading of one was found to be 78.0 (p<0.001). Conclusion: In this study, we detected patients with PID with MRI and revealed that there is a significant relationship between high PI degree and PID and spondylolisthesis. When high PI is detected in patients with PID, predicting that spondylolisthesis may develop in these patients is an important finding that will shape follow-up and treatment.

Keywords

• Pars interarticularis
• spondylolisthesis
• pelvic incidence

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