Opinions differ as to the exact mechanism responsible for spondylolysis (SP) and whether individuals with specific morphological
characteristics of the lumbar vertebral neural arch are predisposed to SP. The aim of our study was to reveal the association
between SP and the architecture of lumbar articular facets and the inter-facet region.
Methods: Using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA, USA), length, width and depth of all articular
facets and all inter-facet distances in the lumbar spine (L1–L5) were measured. From the Hamann-Todd Human Osteological Collection
(Cleveland Museum of Natural History, OH, USA) 120 normal male skeletons with lumbar spines in the control group and 115 with
bilateral SP at L5 were selected. Analysis of variance was employed to examine the differences between spondylolytic and normal
spines.
Results: Three profound differences between SP and the norm appeared: (1) in individuals with SP, the size and shape of L4’s neural
arch had significantly greater inter-facet widths, significantly shorter inter-facet heights and significantly shorter and
narrower articular facets; (2) only in the L4 vertebra in individuals with SP was the inferior inter-facet width greater in
size than the superior inter-facet width of the vertebra below (L5) (38.7 mm versus 40 mm); (3) in all lumbar vertebrae, the
right inferior articular facets in individuals with SP were flatter compared to the control group.
Conclusions: Individuals with L4 “SP” characteristics are at a greater risk of developing fatigue fractures in the form of spondylolysis
at L5.
Keywords Spondylolysis - Inter-facet distances - Facet shape - Lumbar vertebra