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Toshinori Sakai, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Kosaku Higashino, Akihiro Nagamachi, Koichi Sairyo
STUDY DESIGN: A retrospective review of prospectively collected data. OBJECTIVE: To investigate recent outcomes of conservative treatment for bony healing in pediatric patients with lumbar spondylolysis (LS) and to identify the problems that need to be resolved. SUMMARY OF BACKGROUND DATA: Several diagnostic and therapeutic techniques for LS have been developed recently, leading to better outcomes for bony healing. METHODS: Overall, 63 consecutive pediatric patients (53 boys and 10 girls) with LS (average age: 13...
October 17, 2016: Spine
Peter T McCunniff, Hojun Yoo, Charles Yu, Navkirat S Bajwa, Jason O Toy, Uri M Ahn, Nicholas Ahn
This study examined the effect of bilateral and unilateral L5 pars defects on the degree of disk degeneration at the L5-S1 level in cadaveric specimens. An observational study was performed of 690 cadaveric specimens selected at random. These specimens represent individuals who died between 1893 and 1938. The study included 558 male and 132 female cadavers. Of the 120 specimens with L5 spondylolysis, 95 cases were bilateral and 25 were unilateral. The remaining 544 specimens were used as the control cohort...
September 29, 2016: Orthopedics
Timothy McKenna, Cara C Prideaux
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Josef N Tofte, Tyler L CarlLee, Andrew J Holte, Sean E Sitton, Stuart L Weinstein
STUDY DESIGN: Systematic Review. OBJECTIVE: To provide an evidence-based recommendation for when and how to employ imaging studies when diagnosing back pain thought to be caused by spondylolysis in pediatric patients. SUMMARY OF BACKGROUND DATA: Spondylolysis is a common structural cause of back pain in pediatric patients. The radiologic methods and algorithms used to diagnose spondylolysis are inconsistent among practitioners. METHODS: A literature review was performed in PubMed and Cochrane databases using the search terms "spondylolysis" "pediatric" "adolescent" "juvenile" "young" "lumbar" "MRI" "bone scan" "CT" and "SPECT"...
September 23, 2016: Spine
Yasuaki Imajo, Toshihiko Taguchi, Masashi Neo, Koji Otani, Tadanori Ogata, Hiroshi Ozawa, Naohisa Miyakoshi, Hideki Murakami, Tetsuhiro Iguchi
BACKGROUND: The Japanese Society for Spine Surgery and Related Research (JSSR) performed a third study on complications in spinal surgery in 2011. The purpose was to present information about surgery and complications in a large amount of elderly patients aged 65 years with lumbar spinal stenosis (LSS) without coexisting spondylolisthesis, spondylolysis, or scoliosis, and to compare patients aged ≥80 years to those aged 65-79 years. METHODS: A recordable optical disc for data storage was sent by JSSR in January 2012 to 1105 surgeons certified by the JSSR in order to collect surgical data...
September 16, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
James T Bennett, Kenneth J Zook, Peter M Eyvazzadeh, Paul S Lin
OBJECTIVE: A novel motion-preserving technique to directly repair pars defects. Moreover, the indications for repair are expanded to include those with disc disease and associated spondylolisthesis. SUMMARY OF BACKGROUND DATA: The challenge in treating pars defects has been that there are few techniques available to stabilize them adequately. Treatment has focused on fusion across the inter-space versus grafting and instrumentation of the defect itself. We hypothesize that direct repair of the defect favors maintenance of normal motion characteristics by preserving the functional unit of the disc...
September 10, 2016: Surgical Technology International
C Fleege, M Arabmotlagh, W Rother, M Rauschmann, M Rickert
INTRODUCTION: For the treatment of isthmic spondylolisthesis two alternative interbody fusion techniques are available, the dorsoventral interposition in ALIF technique and the dorsal access interposition in PLIF technique. Due to the complications of anterior lumbar surgery and in order to avoid a second operation, the dorsoventral fusion technique is becoming uncommon and mainly a pure dorsal supply is performed. The aim of the study was to compare the clinical long-term results of both treatment techniques...
September 2016: Der Orthopäde
Pilar Rovira Martí, Rosendo Ullot Font
PURPOSE: Pycnodysostosis is a rare autosomal recessive genetic disorder usually diagnosed at an early age. The few previously published case series have generally focused on maxillofacial manifestations and genetic considerations. The purpose of this study was to evaluate the clinical characteristics and differential diagnosis of pycnodysostosis focusing on its orthopaedic manifestations, which have been poorly described in the literature. METHODS: We evaluated clinical and radiographic characteristics of five patients with pycnodysostosis...
August 25, 2016: International Orthopaedics
Pavlos Panteliadis, Navraj S Nagra, Kimberley L Edwards, Eyal Behrbalk, Bronek Boszczyk
STUDY DESIGN: Narrative review. OBJECTIVE: The study aims to critically review the outcomes associated with the surgical repair or conservative management of spondylolysis in athletes. METHODS: The English literature listed in MEDLINE/PubMed was reviewed to identify related articles using the term "spondylolysis AND athlete." The criteria for studies to be included were management of spondylolysis in athletes, English text, and no year, follow-up, or study design restrictions...
September 2016: Global Spine Journal
Jia Min, Jian Wang, Zheng Feng Zhang, Wen Jie Zheng, Yue Zhou
STUDY DESIGN: Retrospective analysis of the clinical outcomes of eight patients with the lumbar pars interarticulars defects treated by direct repair with the aid of intraoperative O-arm based navigation and microendoscopic techniques. OBJECTIVE: To investigate the efficacy and safety of direct screw repair by using minimally invasive surgery for the lumbar pars interarticulars defects in a pilot study. SUMMARY OF BACKGROUND DATA: Direct repair of pars interarticulars defects has been used to treat young adult patients...
August 3, 2016: Spine
L Michael Kershen, Nicholas C Nacey, James T Patrie, Michael G Fox
PURPOSE: To determine the accuracy and short-term efficacy of fluoroscopy-guided steroid/anesthetic injections for symptomatic pars interarticularis (pars) defects. MATERIALS AND METHODS: Following IRB approval, all fluoroscopically guided pars injections from a single institution (6/2010 to 3/2016) were retrospectively and independently reviewed by two MSK radiologists. The radiologists evaluated the fluoroscopic images to determine if all of the pars injections associated with each procedure were intra-pars (n = 57 procedures; 106 pars injections), peri-pars (n = 3 procedures; three pars injected), or a combination of intra-pars and peri-pars (n = 6 procedures; 12 pars injected)...
October 2016: Skeletal Radiology
Eric Welder, Anastasia Fischer, Kristine Graft, Reno Ravindran, Eric Peters, Richard Rodenberg, James MacDonald, Mitchell Selhorst
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
Julio Urrutia, Tomas Zamora, Jorge Cuellar
STUDY DESIGN: Cross sectional study. OBJECTIVE: To compare the prevalence of lumbar spondylolysis and spina bifida occulta (SBO) in pediatric and adult populations. SUMMARY OF BACKGROUND DATA: The prevalence of spondylolysis reported from radiograph-based studies in children had been questioned in Computed Tomography (CT)-based studies in adults; however, a recent CT-based study in pediatric patients has confirmed the previously reported data in pediatric populations...
June 28, 2016: Clinical Spine Surgery
Mitchell Selhorst, Anastasia Fischer, Kristine Graft, Reno Ravindran, Eric Peters, Richard Rodenberg, Eric Welder, James MacDonald
OBJECTIVES: The purposes of this study were (1) to determine whether the duration of rest before referral to physical therapy (PT) affects the time to make a full return to activity for patients with an acute spondylolysis, (2) to assess the safety of an early referral to PT in patients with an acute spondylolysis. STUDY DESIGN: Retrospective chart review. SETTING: Hospital-based sports medicine clinic. PATIENTS: The medical charts of 196 adolescent athletes (mean age = 14...
June 22, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Hesham Magdi Soliman
BACKGROUND CONTEXT: Spondylolysis is a common source of low back pain in children and adolescents. Despite the benign natural history of the pathology, however it should be noted that as a part of the conservative management many young individuals are forced to discontinue their routine sport activities. In cases resistant to conservative management, direct repair of a pars defect is considered a safe and effective option in young adults with preserved discs. Recently, some reports of minimally invasive pars repair have been described, aiming at preservation of the paraspinal muscles and improvement of the postoperative course...
June 23, 2016: Spine Journal: Official Journal of the North American Spine Society
Tetsuya Kimura, Toshinori Sakai, Fumitake Tezuka, Mitsunobu Abe, Kazuta Yamashita, Yoichiro Takata, Kosaku Higashino, Koichi Sairyo
We report a case with compression myelopathy due to proliferative changes around the C2 pars defects without instability. A 69-year-old man presented with progressive clumsy hands and spastic gait. Plain radiographs showed bilateral spondylolysis (pars defects) at C2 and fusion between C2 and C3 spinous processes. Dynamic views revealed mobility through the pars defects, but there was no apparent instability. Computed tomography showed proliferative changes at the pars defects, which protruded into spinal canal...
June 2016: Asian Spine Journal
Fumitake Tezuka, Koichi Sairyo, Toshinori Sakai, Akira Dezawa
STUDY DESIGN: Case series. OBJECTIVE: The purpose of this paper is to present a case series of fresh stress fractures (spondylolysis) in the lumbar spines of adult athletes. SUMMARY OF BACKGROUND DATA: Lumbar spondylolysis is a stress fracture of the pars interarticularis, which is generally considered a disease of children or adolescence. There is only one case series written in English reporting on adult-onset fresh spondylolysis. METHODS: Eleven patients aged 20-27 years are included in this case series...
June 20, 2016: Clinical Spine Surgery
Linn Helen J Grødahl, Louise Fawcett, Madeleine Nazareth, Richard Smith, Simon Spencer, Nicola Heneghan, Alison Rushton
BACKGROUND: In adolescent athletes, low back pain has a 1-year prevalence of 57% and causes include spondylolysis and spondylolisthesis. An accurate diagnosis enables healing, prevention of progression and return to sport. OBJECTIVE: To evaluate the diagnostic utility of patient history and physical examination data to identify spondylolysis and/or spondylolisthesis in athletes. DESIGN: Systematic review was undertaken according to published guidelines, and reported in line with PRISMA...
August 2016: Manual Therapy
Gregory D Schroeder, Cynthia R LaBella, Marco Mendoza, Erika L Daley, Jason W Savage, Alpesh A Patel, Wellington K Hsu
PURPOSE: To determine if adolescent athletics increases the risk of structural abnormalities in the lumbar spine. METHODS: A retrospective review of patients (ages 10-18) between 2004 and 2012 was performed. Pediatric patients with symptomatic low back pain, a lumbar spine MRI, and reported weekly athletic activity were included. Patients were stratified to an "athlete" and "non-athlete" group. Lumbar magnetic resonance and plain radiographic imaging was randomized, blinded, and evaluated by two authors for a Pfirrmann grade, herniated disc, and/or pars fracture...
September 2016: European Spine Journal
Joshua Adam Delavan, Nicholas V Stence, David M Mirsky, Jane Gralla, Michael F Fadell
BACKGROUND: Limited z-axis-coverage computed tomography (CT) to evaluate for pediatric lumbar spondylolysis, altering the technique such that the dose to the patient is comparable or lower than radiographs, is currently used at our institution. The objective of the study was to determine whether volumetric 3-dimensional fast spin echo magnetic resonance imaging (3D MRI) can provide equal or greater diagnostic accuracy compared with limited CT in the diagnosis of pediatric lumbar spondylolysis without ionizing radiation...
July 2016: Sports Health
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