Spinal Fractures, Spondylolysis and Spondylolysthesis - Osteogenesis Imperfecta - page 381

FIGURE 44.13 Grade I isthmic spondylolisthesis.
(Reproduced with permis sion from Wolters Kluwer Health)

FIGURE 44.12 Diffuse elongated pedicles in a child with
treated OI.

as occurring in patients. Of 121 cases of scoliosis in OI
reported by Yong-Hing and MacEwen, none were noted
to have spondylolysis or spondylolisthesis. 1 Cristofaro
et al. found 71% of patients with OI had scoliosis but
did not report lysis or listhesis. 47 The incidence in the
report by Renshaw et al. was one case of lysis in 54
patients with OI. 4 Hanscomb et al. reported three cases
of lysis and/or listhesis in 64 patients. 18 Both spondy-
lolysis and spondylolisthesis occurring in adults have
been reported in case reports by other authors. 39
More recently, Verra et al. found the prevalence
of pars defect in 5.3% of their OI population but they
excluded children under the age of 6 years. Their study
also did not comment on how many of their patients
were ambulatory. Some, but not all, of the children in
their study were treated with bisphosphonates. 48 Hatz
et al. reported the overall incidence of spondylolysis in
a pediatric population with OI at 8.2% in a review of
lateral X-rays of 110 patients with an average age of 7.5
years; 75% were of the isthmic type and 35% dysplastic.
Hatz et al. also found spondylolisthesis in 10.9% in
patients with an average age of 6.5 years. Some of these
patients had spondylolisthesis from isolated elongation
of the pedicles with grossly normal pars. The combined
incidence of spondylolysis and spondylolisthesis was
19.2%. They did not, however, correlate the type of OI
to these findings. They did note that the vast majority
of the children were ambulatory, and that essentially

FIGURE 44.14 Meyerding classification of spondylolisthesis
basically is broken down into percentages, which allows for monitor-
ing for progression. This can be difficult to use if there is significant
remodeling of the lower vertebral body.
(Reproduced with permission from Wolters Kluwer Health)

defect. 10 An adult patient with spondylolisthesis was
reported by Rask. This individual had a lucency of the
pars that was felt to be secondary to trauma at the age
of 4 years, by history. 46 Few of the larger studies of sco-
liosis in OI mention spondylolysis or spondylolisthesis