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Shengtao Zhang, Conglin Ye, Qi Lai, Xiaolong Yu, Xuqiang Liu, Tao Nie, Haibo Zhan, Min Dai, Bin Zhang
BACKGROUND: Lumbar spondylolysis and isthmic spondylolisthesis are common conditions. However, double-level lumbar spondylolysis and spondylolisthesis are rare. We report 24 cases of it along with a review of literature and a briefly description of the clinical and radiological features and integrated management of patients with this condition. METHODS: Of 1700 inpatients diagnosed with lumbar spondylolisthesis at our hospital between January 2008 and September 2015, we selected those with a diagnosis of double-level spondylolisthesis who underwent surgery...
March 16, 2018: Journal of Orthopaedic Surgery and Research
Matthew E Oetgen
Evidence-based medicine (EBM) is a process of decision-making aimed at making the best clinical decisions as they relate to patients' health. The current use of EBM in pediatric spine surgery is varied, based mainly on the availability of high-quality data. The use of EBM is limited in idiopathic scoliosis, whereas EBM has been used to investigate the treatment of pediatric spondylolysis. Studies on early onset scoliosis are of low quality, making EBM difficult in this condition. Future focus and commitment to study quality in pediatric spinal surgery will likely increase the role of EBM in these conditions...
April 2018: Orthopedic Clinics of North America
Teruaki Ono, Akio Sakamoto, Osamu Jono, Atsushi Shimizu
BACKGROUND Osteoid osteomas are benign bone-forming tumors characterized by local inflammation and pain. They are also characterized by a small osteolytic lesion (nidus). Spondylolysis is a defect of the pars interarticularis, which may lead to stress fractures, and is a common cause of low back pain in adolescence. Osteoid osteoma occurs predominantly in the posterior elements of the spine. Magnetic resonance imaging (MRI) signal abnormality suggesting bone marrow edema is a common finding in osteoid osteoma and early-stage spondylolysis without prominent defect...
February 26, 2018: American Journal of Case Reports
Raza Mushtaq, Jack Porrino, Gloria J Guzmán Pérez-Carrillo
No abstract text is available yet for this article.
February 8, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Woo Young Kang, Joon Woo Lee, Eugene Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang
OBJECTIVE: To assess the efficacy of fluoroscopy-guided facet joint injection for symptomatic spondylolysis and to analyze the outcome predictors. MATERIALS AND METHODS: This study included 108 patients who underwent fluoroscopy-guided facet joint steroid injection for symptomatic spondylolysis with follow-up medical records from January 2013 to December 2016. Among them, 47 patients underwent concomitant epidural steroid injection. Response to injection was assessed at the initial follow-up...
February 2, 2018: Skeletal Radiology
Jinlei Zhang, Yong Hai, Jincai Yang, Aixing Pan, Yangpu Zhang
OBJECTIVE: To explore the clinical and spinopelvic features in patients with lumbar spondylolisthesis and degenerative lumbar scoliosis (LSDLS) and those with standalone lumbar spondylolisthesis (SALS). PATIENTS AND METHODS: We retrospectively analyzed 130 patients with lumbar spondylolisthesis seen between 05/2013 and 12/2016 in our hospital. Propensity score matching was used to reduce an age distribution imbalance between the two groups. Clinical and spinopelvic parameters were compared by independent samples t test and chi-square test...
January 19, 2018: Clinical Neurology and Neurosurgery
Marc O'Donnell, William F Lavelle, Mike H Sun
Spondylolysis is frequently seen in adolescents, typically at the L5 vertebral level. While there may be a congenital predisposition for spondylolysis, it has long been suggested that the defect results from a fatigue or stress fracture of the pars interarticularis. Spondylolisthesis may result from a bilateral spondylolytic defect and is frequently asymptomatic. There is a paucity of literature on infant and toddler spondylolysis, as the focus is primarily on school-aged children, typically those over ten years of age...
December 2017: Journal of Spine Surgery (Hong Kong)
Paola D'Aprile, Michelangelo Nasuto, Alfredo Tarantino, Samantha Cornacchia, Giuseppe Guglielmi, J Randy Jinkins
PURPOSE: To examine both anterior and posterior elements of the lumbar spine in patients with low back pain using MRI T2-weighted sequences with Fat Saturation (FS) and contrast enhanced T1-weighted sequences with FS. MATERIALS AND METHODS: Two thousand eight hundred and twenty (2820) patients (1628 male, 1192 female, mean age 54) presenting low back pain underwent MRI standard examination (Sagittal T1w TSE and T2w TSE, axial T1 SE) with the addition of sagittal and axial T2w Fat Sat (FS) sequences...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
John J Winslow, Mark Jackson, Andrew Getzin, Michael Costello
OBJECTIVE:   To describe the conservative management of a young athlete with extension-based (EB) low back pain (LBP). BACKGROUND:   We present the case of a 15-year-old female high school gymnast with a 4-year history of EB LBP. Magnetic resonance imaging revealed a healed spondylolysis and significant lumbar multifidi muscle (LMM) atrophy with fatty infiltrate. She had several courses of outpatient orthopaedic rehabilitation that focused on core muscle strengthening (improving activation and strength of the LMM and transversus abdominus muscle in a neutral pelvic position) without long-lasting improvement...
January 19, 2018: Journal of Athletic Training
Nasser Mohammed, Devi Prasad Patra, Vinayak Narayan, Amey R Savardekar, Rimal Hanif Dossani, Papireddy Bollam, Shyamal Bir, Anil Nanda
OBJECTIVE Spondylosis with or without spondylolisthesis that does not respond to conservative management has an excellent outcome with direct pars interarticularis repair. Direct repair preserves the segmental spinal motion. A number of operative techniques for direct repair are practiced; however, the procedure of choice is not clearly defined. The present study aims to clarify the advantages and disadvantages of the different operative techniques and their outcomes. METHODS A meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines...
January 2018: Neurosurgical Focus
Kazuta Yamashita, Toshinori Sakai, Yoichiro Takata, Fumio Hayashi, Fumitake Tezuka, Masatoshi Morimoto, Yutaka Kinoshita, Akihiro Nagamachi, Takashi Chikawa, Hiroshi Yonezu, Kosaku Higashino, Tadanori Sakamaki, Koichi Sairyo
Lumbar spondylolysis usually occurs as a stress fracture in the pars interarticularis of the vertebra. It is a prevalent sports-related disorder and a common cause of low back pain. We encountered five athletes (4 males, 1 female) with severe low back pain. Mean age was 14.5 years. All five patients were found to have bilateral pars fracture. In all cases, staging based on the findings from computed tomography scan of the right and left pars fracture was different. On short tau inversion recovery magnetic resonance imaging (STIR-MRI) of the comparatively newer more recently injured side, high signal intensity changes were obvious and dominant at the intra- and extraosseous area, which would indicate tissue edema and/or bleeding...
December 25, 2017: Neurologia Medico-chirurgica
L F Tu, Y P Chen, S P Zhang
OBJECTIVES: To explore the casual relationship and the significance of identification among the injury, disease and damage consequence in the disability evaluation of lumbar spondylolysis by the standard for identifying grading of disability caused by work-related injuries. METHODS: The general data, injury manner, clinical treatment and the imaging examination of 32 lumbar spondylolysis cases were collected and retrospectively analyzed. According to the degree of participation in the injury and damage consequence, the identification and assessment of casual relationship was made, and the grading of disability was assessed...
June 2017: Fa Yi Xue za Zhi
Eun Kyoung Kang, Hee-Won Park, Sung Hyun Kim, Sora Baek
Objective: To elucidate the association between non-specific low back pain (NSLBP) and spinal X-ray findings in Korean farmers: Farmers' Cohort for Agricultural Work-Related Musculoskeletal disorders (FARM) study. Methods: A total of 835 farmers (391 males, 444 females; mean age, 56.6±7.4 years) without red-flag signs of specific LBP were recruited. Presence of LBP more than one week or once a month with more than moderate degree of pain severity during the last year was assessed with a binary questionnaire (yes or no)...
October 2017: Annals of Rehabilitation Medicine
M D D'Angelo Del Campo, J A Suby, P García-Laborde, R A Guichón
Spondylolysis is a fracture of the pars interarticularis, the portion of the neural arch that lies between the superior articular facets and the inferior articular facets. Clinical evidence has suggested repetitive trauma to be the most probable cause, even though morphological weakness of the vertebra is probably also involved. Prevalence is between 3% and 8% in modern populations, while in archaeological samples it varies from 0% to 71.4%. Considering that very little data about this condition is available in past populations from the southern extreme of South America, the aim of this paper is to analyze the spondylolysis in a human skeletal sample from Southern Patagonia and, at the same time, to explore the prevalence of spondylolysis in archaeological contexts around the world to gain a better understanding of the results presented here...
December 2017: International Journal of Paleopathology
Jonathan N Sellin, Jeffrey S Raskin, Kristen A Staggers, Alison Brayton, Valentina Briceño, Amee J Moreno, Andrew Jea
Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery...
November 17, 2017: Journal of Neurosurgery. Pediatrics
Mitchell Selhorst, Anastasia Fischer, James MacDonald
OBJECTIVE: To assess the risk of spondylolysis by sport in nonelite adolescent athletes with low back pain (LBP). DESIGN: Retrospective case series. SETTING: Hospital-based sports medicine clinic. PATIENTS: The medical charts of 1025 adolescent athletes with LBP (age 15 ± 1.8 years) were examined; 308 (30%) were diagnosed with a spondylolysis. ASSESSMENT OF RISK: Risk of spondylolysis was assessed in 11 sports for males and 14 sports for females...
November 14, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Tishya A L Wren, Skorn Ponrartana, Patricia C Aggabao, Ervin Poorghasamians, David L Skaggs, Vicente Gilsanz
STUDY DESIGN: A cross-sectional comparison of vertebral morphology and lumbar lordosis (LL) in adolescents with and without spondylolysis. OBJECTIVE: To test the hypothesis that in addition to LL, vertebral cross-sectional area (CSA) is also associated with spondylolysis. SUMMARY OF BACKGROUND DATA: Recent data indicates that the CSA of the vertebral body is a determinant of LL, which has been shown to be associated with spondylolysis. METHODS: Using magnetic resonance imaging, we compared the degree of LL from L1 to L5 and the CSA of the lumbar vertebrae in 35 adolescents (16 females and 19 males) with spondylolysis and 86 healthy controls (36 females and 50 males) of similar sex, age, height, and weight...
October 31, 2017: Spine
John Paul G Kolcun, Lee Onn Chieng, Karthik Madhavan, Michael Y Wang
Spondylolysis from pars fracture is a common injury among young athletes, which can limit activity and cause chronic back pain. While current literature has examined the relative benefits of surgical and conservative management of these injuries, no study has yet compared outcomes between conventional direct repair of pars defects and modern minimally invasive procedures. The goals of surgery are pain resolution, return to play at previous levels of activity, and a shorter course of recovery. In this review, the authors have attempted to quantify any differences in outcome between patients treated with conventional or minimally invasive techniques...
October 2017: Asian Spine Journal
Brandon L Raudenbush, Reid C Chambers, Michael P Silverstein, Ryan C Goodwin
BACKGROUND: Isthmic spondylolysis (ISY) is a common cause of back pain in the pediatric population. Historically, non-operative treatments have had a very high success rate. The purpose of this study was to review the mid-term results of an indirect pars repair technique on reducing the visual analog score for pain (VAS), spondylolysis defect healing, complication rates and rates of return to pre-surgery activity level in pediatric patients who failed conservative care for ISY. METHODS: A retrospective review of all pediatric patients (<18 years old) treated surgically by one surgeon over a 5-year period was performed...
September 2017: Journal of Spine Surgery (Hong Kong)
Mathew R Voisin, Christopher D Witiw, Ryan Deorajh, Daipayan Guha, Adetunji Oremakinde, Shelly Wang, Victor Yang
BACKGROUND/OBJECTIVE: Multilevel spondylolysis is a rare cause of progressive lower back pain, and patients who fail conservative management are treated surgically. Direct repair methods can maintain mobility and lead to decreased morbidity compared with spinal fusion in single-level spondylolysis. In this paper, we present a patient with nonadjacent multilevel spondylolysis who underwent the "smiley face" technique of direct multilevel repair without fusion using 3-dimensional intraoperative spinal navigation...
January 2018: World Neurosurgery
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