Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 4 Issue 10

Frequency of Under-Reporting of Lumbar Spondylolysis and Spondylolisthesis on Abdomino-Pelvic CT in Non-Traumatic Patients at Tertiary Care Hospital

Arif Abu Bakar1, Rizwan Ajmal1, Ameet Jesrani2*, Muhammad Ayub Mansoor1, Roomi Mahmud1 and Sehrish Sethar2

1Department of Radiology, Liaquat National Hospital, Karachi, Pakistan
2Department of Radiology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan

*Corresponding Author: Ameet Jesrani, Department of Radiology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.

Received: September 01, 2020; Published: September 25, 2020



Background: Many incidental deformities of musculoskeletal system can usually be adequately recognized through abdominopelvic CT scans. However, abnormalities such as spondylolysis and spondylolisthesis are generally missed by radiologist due to lack of sagittal images on a routine abdominal CT.

Objective: To find out the prevalence of unreported cases of spondylolysis and spondylolisthesis in non-traumatic population undergoing abdominopelvic CT scan at a tertiary care hospital.

Study Design: Cross sectional study.

Setting: Department of Radiology, Liaquat National Hospital, Karachi.

Duration: From 13th August 2017 to 12th February 2018.

Material and Methods: We conducted a cross sectional study on 196 abdominopelvic CT scans of patients without any history of trauma. Two consultant radiologists commented on absence or presence of spondylolysis and spondylolisthesis. The spondylolisthesis was further graded and spondylolysis was divided as unilateral or bilateral. Under reporting was evaluated by whether one consultant reported lesser cases than the other. Then descriptive statistics were calculated and stratification was performed. Finally, we applied post stratification chi square test. P value of < 0.05 was taken as significant.

Results: Of 196 patients recruited, 103 were males and 93 were females. 51.53 ± 12.14 years were the mean age of our study population. Spondylolysis was identified in 46.4% with 76.6% unilateral cases and 23.4% bilateral cases. 54.6% cases were diagnosed as spondylolisthesis. Grade I, II and V were 18.7% each. Whereas grade III was 22.4% and grade IV was 21.5%. 52.0% cases were underreported as observed in this study.

Conclusion: Under reporting in 52.0% of cases suggest that this may result in delayed treatment of spondylolysis and spondylolisthesis.

Keywords: Under Reporting; Lumbar Spondylolysis; Spondylolisthesis; Abdomino-Pelvic CT; Nontraumatic Patients



  1. D Hemecourt P., et al. “Back Injuries in the young athlete”. Clinics in Sports Medicine 19 (2000): 663-679.
  2. Micheli L and Wood R. “Back pain in young athletes: significant differences from adults in causes and patterns”. Archives of Pediatrics and Adolescent Medicine 149 (1995): 15-18.
  3. Tsirikos A and Garrido E. “Spondylolysis and spondylolisthesis in children and adolescents”. Journal of Bone and Joint Surgery 6 (2010): 751-759.
  4. Denard P., et al. “Back pain, neurogenic symptoms, and physical function in relation to spondylolisthesis among elderly men”. The Spine Journal 10 (2010): 865-873.
  5. Ahn UM., et al. “Functional outcome and radiographic correction after spinal osteotomy”. Spine12 (2002): 1303-1311.
  6. Herbiniaux G. “Traitesur divers accouchemenslabprieuxetsurpolypes de la matrice”. Brussels: JL De Boubers (1782).
  7. Lonstein JE. “Spondylolisthesis in children. Cause, natural history, and management”. Spine24 (1999): 2640-2648.
  8. Nazarian S. “Spondylolysis and spondylolytic spondylolisthesis. A review of current concepts on pathogenesis, natural history, clinical symptoms, imaging, and therapeutic management”. European Spine Journal 2 (1992): 62-83.
  9. Harris IE and Weinstein SL. “Long-term follow-up of patients with grade-III and IV spondylolisthesis treatment with and without posterior fusion”. Journal of Bone and Joint Surgery American 7 (1987): 960-969.
  10. Leone A., et al. “Imaging of lumbar spondylolysis”. The Radiologist 8 (2001): 73-86.
  11. Rauch RA and Jinkins JR. “Lumbosacral spondylolisthesis associated with spondylolysis”. Neuroimaging Clinics of North America 3 (1993): 543-553.
  12. Taillard WF. “Etiology of spondylolisthesis”. Clinical Orthopaedics 117 (1976): 30-39.
  13. Mihara H., et al. “The biomechanical effects of spondylolysis and its treatment”. Spine 28 (2003): 235-238.
  14. Floman Y. “Progression of lumbosacral isthmic spondylolisthesis in adults”. Spine 25 (2000): 342-347.
  15. Inoue H., et al. “Radiographic classification of L5 isthmic spondylolisthesis as adolescent or adult vertebral slip”. Spine 27 (2002): 831-838.
  16. Teplick JG., et al. “Diagnosis and evaluation of spondylolisthesis and/or spondylolysis on axial CT”. American Journal of Neuroradiology 7 (1986): 479-491.
  17. Araki T., et al. “Reactive sclerosis of the pedicle associated with contralateral spondylolysis”. Spine 17 (1992): 1424-1426.
  18. Harvey CJ., et al. “The radiological investigation of lumbar spondylolysis”. Clinical Radiology 53 (1998): 723-728.
  19. Beutler WJ., et al. “The natural history of spondylolysis and spondylolisthesis: 45-year follow-up evaluation”. Spine 28 (2003): 1027-1035.
  20. Majumdar SR., et al. “Incidental vertebral fractures discovered with chest radiography in the emergency department”. Archives of Internal Medicine 165 (2005): 905-909.
  21. Melton LJ., et al. “Epidemiology of vertebral fractures in women”. American Journal of Epidemiology 129 (1989): 1000-1011.
  22. Gehlbach SH., et al. “Recognition of vertebral fractures in a clinical setting”. Osteoporosis International 11 (2000): 577-582.
  23. Bartalena T., et al. “Prevalence of thoracolumbar vertebral fractures on multidetector CT: underreporting by radiologists”. European Journal of Radiology 3 (2009): 555-559.
  24. Obaid H., et al. “Underdiagnosis of vertebral collapse on routine multidetector computed tomography scan of the abdomen”. Acta Radiologica 7 (2008): 795-800.
  25. Williams AL., et al. “Under-reporting of osteoporotic vertebral fractures on computed tomography”. European Journal of Radiology 1 (2009): 179-183.
  26. Kado DM., et al. “Vertebral fractures and mortality in older women: a prospective study-study of Osteoporotic Fractures Research Group”. Archives of Internal Medicine 11 (1999): 1215-1220.
  27. Belfi LM., et al. “Computed tomography evaluation of spondylolysis and spondylolisthesis in asymptomatic patients”. Spine24 (2006): E907-E910.


Citation: Ameet Jesrani., et al. “Frequency of Under-Reporting of Lumbar Spondylolysis and Spondylolisthesis on Abdomino-Pelvic CT in Non-Traumatic Patients at Tertiary Care Hospital". Acta Scientific Medical Sciences 4.10 (2020): 130-135.


Acceptance rate35%
Acceptance to publication20-30 days
Impact Factor1.183

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US