Lumbar spine in Marfan syndrome.

Lumbar spine radiographs of 28 patients with Marfan syndrome and a gender and age-matched control group were evaluated for scoliosis and morphologic changes of the L2, L3, and L4 vertebrae. No patient or control subject had any serious low back problems. The Marfan patients showed a high incidence of scoliosis (64%). The incidence of lumbosacral transitional vertebra was also high (18%). The end plates of the vertebral bodies in the Marfan patients were more biconcave than in the control group. In addition, the transverse processes were longer in relation to the vertebral body width in the Marfan group than in the controls. These findings indicate that biconcave vertebral bodies can be added to the list of skeletal manifestations of the Marfan syndrome, and Marfan syndrome to the list of differential diagnoses for biconcave vertebrae ("codfish vertebrae").

Lumbar spine mobility in Marfan syndrome. A clinical and radiological study.

Low back pain symptoms and lumbar spine mobility were assessed by questionnaires and by clinical and radiological measurements in 32 patients with Marfan syndrome. Frequently occurring low back pain was reported by 19% of the patients, but the disability was slight in all of them. Flexion and extension mobility of the lumbar spine (L1-S1) assessed from radiographs was 59.9 degrees and 13.2 degrees, respectively. Mean lumbar angular mobility between flexion and extension radiographs was 7.4 degrees at L1-2, 13.2 degrees at L2-3, 16.0 degrees at L3-4, 19.3 degrees at L4-5 and 18.3 degrees at L5-S1. No correlation was found between the manual assessment of lumbar segmental instability and radiological translatory motion, except at L2-3, where the correlation was negative (r = -0.41, P < 0.05). In conclusion, the prevalence of low back pain does not seem to differ substantially between Marfan syndrome patients and the normal population, and it seems that there is at most a slight hypermobility of the lumbar spine in Marfan syndrome. Several validity problems are encountered in the manual assessment of lumbar instability.