Spinal Fractures, Spondylolysis and Spondylolysthesis - Osteogenesis Imperfecta - page 380

(A) (B) (C)

(D) (E)

FIGURE 44.11 Recurrent injury and healing of the pars. (A) December 2005 - acute back pain with apparent lysis L5 with acute spasm and
flattening of the typical lordotic lumbar curve. (B) March 2007 - clear-cut lysis with grade I spondylolisthesis. (C) March 2010 - elongated pars
with no change in listhesis, but difficult to see lysis. (D) March 2011 - sitting film with clearly visualized chronic lysis. Note also the significant
change in pelvic tilt with sitting. (E) April 2012 - standing film suggesting healed but elongated pars. Unclear if this is just positional and limita-
tions of plain radiographs.

below ( Figure 44.13 ). It is most commonly measured
by the criteria described by Meyerding ( Figure 44.14 ). 44
Listhesis of less than 50% is classified as low-grade
and greater than 50% as high grade. The incidence
of spondylolisthesis in children has been reported to
be around 5% at about 7 years of age. 43 Herman and
Pizzutillo stated that the incidence of spondylolisthesis
was less than 3% in children and between 6 and 8% in
adulthood. 35

Spinal problems and deformities have obviously
been reported in a very high percentage of individuals
with OI, but the vast majority of these reports address
scoliosis. 1-4,10,14,19 Spondylolysis and spondylolisthesis
have been rarely reported in patients with OI. Barrack
reported a symptomatic spondylolysis in a patient with
OI following a spinal fusion that ended at L4. 45 King
and Bobechko reported on children with OI who had
spondylolisthesis and elongated pedicles without a pars