ArticleJournal of spine surgery (Hong Kong)2025
Prevalence of occult spina bifida in isthmic versus degenerative spondylolisthesis: retrospective radiographic review of consecutive surgical patients.
Article in Journal of spine surgery (Hong Kong), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Spondylolisthesis is defined as the anterior or posterior translation of one vertebral body over another. Spina bifida occulta (SBO) is a developmental anomaly characterized by the incomplete fusion of the laminae of one or more vertebral arches along the midline. Currently, there is no documented prevalence of SBO in patients with degenerative spondylolisthesis (DS) undergoing spinal surgery. This study aims to estimate the prevalence of SBO in patients with DS undergoing spine surgery and compare it with that in patients with isthmic spondylolisthesis (IS) undergoing surgery. Methods: Our study is a cross-sectional retrospective review of consecutive patient records from two major tertiary hospitals in Sydney, Australia, covering the period from January 1 Results: Among the patients who underwent spinal surgery, 23.4% were found to have spondylolisthesis due to either degenerative changes or isthmic pars defects at L4/L5 or L5/S1. Within the DS group, the prevalence of SBO was 11.9% (all at the S1 level), while 24.7% of the IS group exhibited SBO. The male-to-female ratio for patients with IS and SBO was 3.6:1, compared to 0.66:1 for those with DS and SBO. Conclusions: SBO is a frequently overlooked anatomical variation in adult spine surgery, particularly in cases of degenerative and IS. With a prevalence of 11.9% in DS, it is crucial for spine surgeons to be vigilant, especially during open posterior lumbar spine fusion surgeries, to prevent unintended durotomy and neurological damage. Awareness of the absence of the S1 spinous process is essential for effective surgical planning, particularly when using navigated spinous process clamps for pedicle screw placement.
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