{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T19:17:04Z","timestamp":1783192624731,"version":"3.54.6"},"reference-count":14,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T00:00:00Z","timestamp":1666051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Spondylolysis occurs bilaterally or unilaterally and bilateral spondylolysis increases the risk of developing isthmic spondylolisthesis. The characteristics of the lumbar lordosis angle (LLA), sacral slope angle (SSA), and spondylolysis fracture angle (SFA) in bilateral spondylolysis compared with those in unilateral spondylolysis have not been clarified. The purpose of this study was to compare the LLA, SSA, and SFA of bilateral and unilateral spondylolysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>Thirty-eight patients with lumbar spondylolysis who visited our clinic for an initial visit and 15 age-matched patients with a chief complaint of low back pain were included as controls. Computed tomography films were used to classify all spondylolysis patients into two groups: those with bilateral fractures (bilateral) and those with unilateral fractures (unilateral). The LLA and SSA were measured using lateral X-ray films and the SFA was measured using computed tomography films.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The LLA was significantly higher in all spondylolysis patients than in the control group (p = .026). There was no significant difference in SSA between the spondylolysis and control groups (p = .28). The LLA was significantly higher in the bilateral group than in the unilateral group (p = .018). There was no significant difference in SSA between the bilateral and unilateral groups (p = .15). The SFA was significantly lower in the bilateral group than in the unilateral group (p = .024).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study suggests that physical therapy for spondylolysis may be considered bilaterally and unilaterally.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0276337","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T17:32:03Z","timestamp":1666114323000},"page":"e0276337","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of alignment and spondylolysis fracture angle in bilateral and unilateral spondylolysis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-2557","authenticated-orcid":true,"given":"Kanta","family":"Matsuzawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshikazu","family":"Azuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Miyazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machiko","family":"Hiramoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruo","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7669-6719","authenticated-orcid":true,"given":"Noriyuki","family":"Kida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Morihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,18]]},"reference":[{"key":"pone.0276337.ref001","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s00776-010-1454-4","article-title":"Incidence and etiology of lumbar spondylolysis: review of the literature","volume":"15","author":"T Sakai","year":"2010","journal-title":"Journal of Orthopaedic Science"},{"key":"pone.0276337.ref002","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1097\/JSA.0000000000000127","article-title":"Review of pediatric spondylolysis and spondylolisthesis","volume":"24","author":"RM Randall","year":"2016","journal-title":"Sports Medicine and Arthroscopy Review"},{"key":"pone.0276337.ref003","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ptsp.2019.02.005","article-title":"Return to play after conservative and surgical treatment in athletes with spondylolysis: A systematic review","volume":"37","author":"R Grazina","year":"2019","journal-title":"Physical Therapy in Sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine"},{"key":"pone.0276337.ref004","doi-asserted-by":"crossref","unstructured":"Cooper G. Non-operative treatment of the lumbar spine. 2015.","DOI":"10.1007\/978-3-319-21443-6"},{"issue":"4","key":"pone.0276337.ref005","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1177\/0363546504269035","article-title":"Athletes with unilateral spondylolysis are at risk of stress fracture at the contralateral pedicle and pars interarticularis: a clinical and biomechanical study","volume":"33","author":"K Sairyo","year":"2005","journal-title":"The American Journal of Sports Medicine"},{"key":"pone.0276337.ref006","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1097\/PHM.0b013e318296da7e","article-title":"Effect of sports modification on clinical outcome in children and adolescent athletes with symptomatic lumbar spondylolysis","volume":"92","author":"G El Rassi","year":"2013","journal-title":"American Journal of Physical Medicine and Rehabilitation"},{"issue":"21","key":"pone.0276337.ref007","doi-asserted-by":"crossref","first-page":"2484","DOI":"10.1097\/01.brs.0000239155.37261.69","article-title":"Sagittal alignment of the spine and pelvis in the presence of L5-s1 isthmic lysis and low-grade spondylolisthesis","volume":"31","author":"P Roussouly","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"key":"pone.0276337.ref008","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.31616\/asj.2018.12.6.1037","article-title":"Segmental lordosis of the spondylolytic vertebrae in adolescent lumbar spondylolysis: differences between bilateral L5 and L4 spondylolysis","volume":"12","author":"K Sugawara","year":"2018","journal-title":"Asian Spine Journal"},{"issue":"2","key":"pone.0276337.ref009","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s00586-001-0349-7","article-title":"The sagittal anatomy of the sacrum among young adults, infants, and spondylolisthesis patients","volume":"11","author":"C Marty","year":"2002","journal-title":"European Spine Journal"},{"issue":"Suppl 5","key":"pone.0276337.ref010","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1007\/s00586-011-1932-1","article-title":"Spino-pelvic sagittal balance of spondylolisthesis: a review and classification","volume":"20","author":"H Labelle","year":"2011","journal-title":"European Spine Journal"},{"key":"pone.0276337.ref011","first-page":"2","article-title":"Spondylolysis fracture angle in children and adolescents on CT indicates the facture producing force vector: A biomechanical rationale","volume":"1","author":"K. Sairyo","year":"2005","journal-title":"The Internet Journal of Spine Surgery"},{"key":"pone.0276337.ref012","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.jor.2021.11.010","article-title":"Rotation-related sports players demonstrate rotation-type lumbar spondylolysis fracture angle and decreased hip internal rotation range of motion","volume":"28","author":"H Nagamoto","year":"2021","journal-title":"Journal of Orthopaedics"},{"key":"pone.0276337.ref013","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/0309364618792746","article-title":"The relationship between lumbar lordosis angle and low back pain in individuals with transfemoral amputation","volume":"43","author":"ME Matsumoto","year":"2019","journal-title":"Prosthetics and Orthotics International"},{"issue":"8","key":"pone.0276337.ref014","first-page":"1123","article-title":"Spondylolysis originates in the ventral aspect of the pars interarticularis: a clinical and biomechanical study","volume":"92","author":"T Terai","year":"2010","journal-title":"The Journal of Bone and Joint Surgery"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0276337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T17:32:34Z","timestamp":1666114354000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0276337"}},"subtitle":[],"editor":[{"given":"Walid Kamal","family":"Abdelbasset","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,10,18]]},"references-count":14,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0276337","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,18]]}}}