Epidemiological differences between the sexes in adolescent patients with lumbar spondylolysis in Japan

Abstract

Abstract Background: Lumbar spondylolysis, a common identifiable cause of low back pain in young athletes, reportedly has a higher incidence rate in males. However, the reason for its higher incidence in males is not clear. This study aimed to investigate the epidemiological differences between the sexes in adolescent patients with lumbar spondylolysis. Methods: A retrospective study was conducted in 197 males and 64 females diagnosed with lumbar spondylolysis. These patients visited our hospital from April 2014 to March 2020 with their main complaint being low back pain, and they were followed-up until the end of their treatment. We investigated associations between lumbar spondylosis, their background factors, and characteristics of the lesions and analyzed their treatment results. Results: Males had a higher prevalence of spina bifida occulta (SBO) (p=0.0026), more lesions with bone marrow edema (p=0.0097), and more lesions in the L5 vertebrae (p=0.021) than females. The age at diagnosis, bone union rate, and treatment period were not significantly different between the sexes. Conclusion: The higher prevalence of SBO in males may explain the sex differences in the incidence of lumbar spondylolysis. The progression of lumbar spondylolysis is however, more advanced in females, thus making a proper early diagnosis, especially in females, important.