{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T01:09:27Z","timestamp":1781831367380,"version":"3.54.5"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program","doi-asserted-by":"crossref","award":["No. 2018YFC2002600"],"award-info":[{"award-number":["No. 2018YFC2002600"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program","doi-asserted-by":"crossref","award":["No.2019YFB1312505"],"award-info":[{"award-number":["No.2019YFB1312505"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Skeletal Radiol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To identify a diagnostic indicator of lumbar spondylolysis visible in plain X-ray films.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>One hundred and seventy-two patients with low back pain who received X-ray and computerized tomography (CT) examinations were identified and studied. They were divided into three groups: the spondylosis without spondylolisthesis (SWS) group, comprising 67 patients with bilateral pars interarticularis defects at L5 and without spondylolisthesis, the isthmic spondylolisthesis (IS) group, comprising 74 patients with L5\/S1 spondylolisthesis and bilateral L5 pars interarticularis defects, and the control group, comprising 31 patients with low back pain but without spondylolysis. The sagittal diameters of the vertebral arch (SDVAs) of L4 and L5 were measured in lateral X-ray image, and the differences in SDVA between L4 and L5 (DSL4-5) in each case were calculated and analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There were no significant differences in demographic characteristics among the three groups. In the SWS and IS groups, the SDVA of L5 was significantly longer than the SDVA of L4 (<jats:italic>p &lt;<\/jats:italic> 0.001), whereas no significant difference found in the control group (<jats:italic>p<\/jats:italic> &gt; 0.05). DSL4-5, in which the SDVA of L4 was subtracted from the SDVA of L5, significantly differed among the three groups (<jats:italic>p<\/jats:italic> &lt; 0.001), and the normal threshold was provisionally determined to be 1.55 mm.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In bilateral L5 spondylolysis, the SDVA of L5 is wider than the SDVA of L4, and this difference is greater in isthmic spondylolisthesis. This sign in lateral X-rays may provide a simple and convenient aid for the diagnosis of spondylolysis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00256-020-03658-8","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T15:03:06Z","timestamp":1603897386000},"page":"1125-1130","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Increased sagittal diameter of the vertebral arch aids in diagnosis of lumbar spondylolysis"],"prefix":"10.1007","volume":"50","author":[{"given":"Shi-Zheng","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An-Ni","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He-Hu","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Jia","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie-Sheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Wei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,28]]},"reference":[{"key":"3658_CR1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.ptsp.2016.04.003","volume":"20","author":"KJ Lawrence","year":"2016","unstructured":"Lawrence KJ, Elser T, Stromberg R. Lumbar spondylolysis in the adolescent athlete. Phys Ther Sport. 2016;20:56\u201360.","journal-title":"Phys Ther Sport"},{"issue":"6","key":"3658_CR2","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1007\/s00256-010-0942-0","volume":"40","author":"A Leone","year":"2011","unstructured":"Leone A, Cianfoni A, Cerase A, Magarelli N, Bonomo L. Lumbar spondylolysis: a review. Skelet Radiol. 2011;40(6):683\u2013700.","journal-title":"Skelet Radiol"},{"key":"3658_CR3","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1097\/01.blo.0000162992.25677.7b","volume":"434","author":"MJ Herman","year":"2005","unstructured":"Herman MJ, Pizzutillo PD. Spondylolysis and spondylolisthesis in the child and adolescent: a new classification. Clin Orthop Relat Res. 2005;434:46\u201354.","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"3658_CR4","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12891-018-2384-0","volume":"20","author":"IM Austevoll","year":"2019","unstructured":"Austevoll IM, Hermansen E, Fagerland M, et al. Decompression alone versus decompression with instrumental fusion the NORDSTEN degenerative spondylolisthesis trial (NORDSTEN-DS); study protocol for a randomized controlled trial. BMC Musculoskelet Disord. 2019;20(1):7.","journal-title":"BMC Musculoskelet Disord"},{"issue":"3","key":"3658_CR5","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.jspd.2017.10.008","volume":"6","author":"E Nielsen","year":"2018","unstructured":"Nielsen E, Andras LM, Skaggs DL. Diagnosis of spondylolysis and spondylolisthesis is delayed six months after seeing nonorthopedic providers sidsmasnp. Spine Deform. 2018;6(3):263\u20136.","journal-title":"Spine Deform"},{"key":"3658_CR6","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/S0030-5898(20)31129-9","volume":"2","author":"LL Wiltse","year":"1971","unstructured":"Wiltse LL. The effect of the common anomalies of the lumbar spine upon disc degeneration and low back pain. Orthop Clin North Am. 1971;2:569\u201382.","journal-title":"Orthop Clin North Am"},{"key":"3658_CR7","first-page":"543","volume":"3","author":"RA Rauch","year":"1993","unstructured":"Rauch RA, Jinkins JR. Lumbosacral spondylolisthesis associated with spondylolysis. Neuroimaging Clin North Am. 1993;3:543\u20135.","journal-title":"Neuroimaging Clin North Am"},{"issue":"3","key":"3658_CR8","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1002\/ca.21222","volume":"25","author":"SB Chung","year":"2012","unstructured":"Chung SB, Lee SJ, Hoon K, et al. Significance of interfacet distance, facet joint orientation, and lumbar lordosis in spondylolysis. Clin Anat. 2012;25(3):391\u20137.","journal-title":"Clin Anat"},{"issue":"6","key":"3658_CR9","doi-asserted-by":"publisher","first-page":"E176","DOI":"10.1097\/01.brs.0000257565.41856.0f","volume":"32","author":"YM Masharawi","year":"2007","unstructured":"Masharawi YM, Najenson DA, Steinberg N, et al. Lumbar facet orientation in spondylolysis: a skeletal study. Spine (Phila Pa 1976). 2007;32(6):E176\u201380.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"3658_CR10","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1002\/ca.21203","volume":"25","author":"Y MASHARAWI","year":"2012","unstructured":"MASHARAWI Y. Lumbar shape characterizations of the neural arch and vertebral body in spondylolysis: a comparative skeletal study. sacss. Clin Anat. 2012;25(2):224\u201330. https:\/\/doi.org\/10.1002\/ca.21203.","journal-title":"Clin Anat"},{"issue":"7","key":"3658_CR11","first-page":"1393","volume":"16","author":"JL Ulmer","year":"1995","unstructured":"Ulmer JL, Mathews VP, Elster AD, King JC. Lumbar spondylolysis without spondylolisthesis: recognitions of isolated posterior element subluxation on sagittal MR. AJNR Am J Neuroradiol. 1995;16(7):1393\u20138.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"1","key":"3658_CR12","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1097\/00008480-200402000-00008","volume":"16","author":"MR Lim","year":"2004","unstructured":"Lim MR, Yoon SC, Green DW. Symptomatic spondylolysis: diagnosis and treatment. Curr Opin Pediatr. 2004;16(1):37\u201346.","journal-title":"Curr Opin Pediatr"},{"issue":"3","key":"3658_CR13","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1148\/radiology.153.3.6494460","volume":"153","author":"M Amato","year":"1984","unstructured":"Amato M, Totty WG, Gilula LA. Spondylolysis of the lumbar spine: demonstration of defects and laminal fragmentation. Radiology. 1984;153(3):627\u20139.","journal-title":"Radiology."},{"issue":"3","key":"3658_CR14","doi-asserted-by":"publisher","first-page":"225","DOI":"10.21037\/tp.2017.06.01","volume":"6","author":"DR Patel","year":"2017","unstructured":"Patel DR, Kinsella E. Evaluation and management of lower back pain in young athletes. Transl Pediatr. 2017;6(3):225\u201335.","journal-title":"Transl Pediatr"},{"issue":"3","key":"3658_CR15","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1097\/BPO.0b013e318287fffb","volume":"33","author":"R Miller","year":"2013","unstructured":"Miller R, Beck NA, Sampson NR, Zhu X, Flynn JM, Drummond D. Imaging modalities for low back pain in children: a review of spondylosis and undiagnosed mechanical back pain. J Pediatr Orthop. 2013;33(3):282\u20138.","journal-title":"J Pediatr Orthop"},{"issue":"9","key":"3658_CR16","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1007\/s00256-015-2138-0","volume":"44","author":"SL Viana","year":"2015","unstructured":"Viana SL, Viana MA, de Alencar EL. Atypical, unusual, and misleading imaging presentations of spondylolysis. Skelet Radiol. 2015;44(9):1253\u201362.","journal-title":"Skelet Radiol"},{"issue":"2","key":"3658_CR17","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1097\/BRS.0b013e31818edcfd","volume":"34","author":"L Kalichman","year":"2009","unstructured":"Kalichman L, Kim DH, Li L, Guermazi A, Berkin V, Hunter DJ. Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population. Spine (Phila Pa 1976). 2009;34(2):199\u2013205.","journal-title":"Spine (Phila Pa 1976)"},{"issue":"1","key":"3658_CR18","doi-asserted-by":"publisher","first-page":"113","DOI":"10.2214\/ajr.134.1.113","volume":"134","author":"G Ravichandran","year":"1980","unstructured":"Ravichandran G. A radiologic sign in spondylolisthesis. AJR Am J Roentgenol. 1980;134(1):113\u20137.","journal-title":"AJR Am J Roentgenol"},{"key":"3658_CR19","first-page":"53","volume":"20","author":"D Bryk","year":"1969","unstructured":"Bryk D, Rosenkranz W. True spondylolisthesis and pseudospondylolisthesis: the spinous process sign. Can Assoc Radiol J. 1969;20:53\u20136.","journal-title":"Can Assoc Radiol J"},{"issue":"6","key":"3658_CR20","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1097\/01241398-198707060-00001","volume":"7","author":"H Saraste","year":"1987","unstructured":"Saraste H. Long-term clinical and radiological follow-up of spondylolysis and spondylolisthesis. J Pediatr Orthop. 1987;7(6):631\u20138.","journal-title":"J Pediatr Orthop"},{"issue":"10","key":"3658_CR21","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.4103\/0366-6999.181972","volume":"129","author":"J Yin","year":"2016","unstructured":"Yin J, Peng BG, Li YC, et al. Differences of sagittal lumbosacral parameters between patient with lumbar spondylolysis and normal adults. Chin Med J. 2016;129(10):1166\u201370.","journal-title":"Chin Med J"},{"issue":"2","key":"3658_CR22","doi-asserted-by":"publisher","first-page":"411","DOI":"10.2214\/ajr.163.2.8037041","volume":"163","author":"JL Ulmer","year":"1994","unstructured":"Ulmer JL, Elster AD, Mathews VP, King JC. Distinction between degenerative and isthmic spondylolisthesis on sagittal MR images: importance of increased anteroposterior diameter of the spinal canal (wide canal sign). AJR Am J Roentgenol. 1994;163(2):411\u20136.","journal-title":"AJR Am J Roentgenol"},{"key":"3658_CR23","first-page":"2017(E)","volume":"8596","author":"International Standard","year":"2017","unstructured":"International Standard. Ophthalmic optics-visual acuity testing-standard and clinical optotypes and their presentation. ISO. 2017;8596:2017(E).","journal-title":"ISO"}],"container-title":["Skeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00256-020-03658-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00256-020-03658-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00256-020-03658-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,10]],"date-time":"2021-04-10T03:28:32Z","timestamp":1618025312000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00256-020-03658-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,28]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["3658"],"URL":"https:\/\/doi.org\/10.1007\/s00256-020-03658-8","relation":{},"ISSN":["0364-2348","1432-2161"],"issn-type":[{"value":"0364-2348","type":"print"},{"value":"1432-2161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,28]]},"assertion":[{"value":"26 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2020","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2020","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 October 2020","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"This study was approved by the Medical Ethics Committee of the China Rehabilitation Research Center, Beijing, China. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare that they have no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}