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Pars interarticularis

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
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
K Venugopal Menon, Sameer B Raniga
BACKGROUND: To date, trabecular morphology studies have been conducted on thin-section computed tomography (CT) scans of cadaveric bone. Here we describe the trabecular anatomy of the axis vertebra as revealed by an innovative imaging tool. METHODS: Ten patients who underwent thin-slice CT scans for suspected cervical spine injury were prospectively subjected to shaded volume-rendered 3-dimensional reconstruction of the images. The trabecular anatomy thus depicted was recreated, and the mechanical vectors were deduced independently by a senior radiologist and spine surgeon and then matched...
February 2018: World 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)
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
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
Keyvan Mostofi, Reza Karimi Khouzani
STUDY DESIGN: Spondylolysis is a defect in the portion of pars interarticularis. The latter affects approximately 6% of the population. It is caused by repetitive trauma in hyperextension. Low back pain is the most common symptom. METHODS: We implanted interspinous process devices in 12 patients with isthmic lysis without spondylolisthesis for low back pain. The purpose of the surgery was to conduct a minimally invasive procedure. RESULTS: In eight cases, patients became asymptomatic...
July 2017: Journal of Craniovertebral Junction and Spine
John Winslow, Andrew Getzin, Hilary Greenberger, Walter Silbert
OBJECTIVE: To evaluate the predictive value of fatty infiltrate of the lumbar multifidus muscles (LMM) for return to play in young athletes with extension-based low back pain (EB LBP). DESIGN: Retrospective cohort study. SETTING: Hospital-based sports medicine practice. PATIENTS: Sixty-two athletes, 61.3% female, and 38.7% male, mean age 14.8 years, with a primary complaint of EB LBP who underwent magnetic resonance imaging (MRI); 46...
August 16, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Naciye Sinem Gezer, Ali Balcı, Orhan Kalemci, Nevin Köremezli, Işıl Başara Akın, Koray Ur
PURPOSE: Spondylolysis is known to be a part of a disease process, which describes a defect in the pars interarticularis of vertebra. We aimed to use quantitative computed tomography (QCT) to measure vertebral body bone mineral density (BMD) in patients with lumbar spondylolysis and compare it with readings in controls. METHODS: Forty symptomatic patients with lumbar spondylolysis aged 18-52 years and 40 matched controls of same sex and approximate age (±2 years) were included in the study...
September 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Jan-Philip Zeden, Jan-Uwe Müller, Ehab Ahmed Mohamed El Refaee, Henry W S Schroeder, Dirk T Pillich
OBJECTIVE In traumatic spondylolistheses of the axis, there is a marked heterogeneity of the observed injury patterns, with a wide range of the severity-from stable fractures, which can be treated conservatively with very good success, to highly unstable fractures, which should be treated surgically. A number of classification systems have been devised to assess the instability of the injuries and to derive a corresponding therapy recommendation. In particular, the results and recommendations regarding medium-severity cases are still inconclusive...
August 2017: Neurosurgical Focus
Hiroyuki Tsuboi, Yukihide Nishimura, Takeshi Sakata, Hideaki Tanina, Hideki Arakawa, Takeshi Nakamura, Yuichi Umezu, Fumihiro Tajima
BACKGROUND: Lumbar spondylolysis is a defect in the pars interarticularis that is common in young athletes; the stress distribution at the pars interarticularis is the highest in extension and rotation movements. The paraspinal muscles play an important role in stabilization of the lumbar spine; however, no study has assessed the properties of paraspinal muscles in athletes with lumbar spondylolysis. OBJECTIVE: To evaluate the properties of paraspinal muscles in athletes with lumbar spondylolysis...
June 30, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Sohail Ahmed Khan, Amjad Sattar, Usman Khanzada, Hatem Adel, Syed Omair Adil, Munawar Hussain
STUDY DESIGN: Descriptive cross-sectional study. PURPOSE: To determine the prevalence of lumbar spondylolysis and spondylolisthesis in a general adult population unrelated to lower back pain as evaluated by multidetector computed tomography. OVERVIEW OF LITERATURE: There is a significant paucity of information related to the prevalence of spondylolysis and spondylolisthesis and its degenerative changes in a general adult population unrelated to lower back pain in developing countries...
June 2017: Asian Spine Journal
Yuichiro Goda, Toshinori Sakai, Taihei Harada, Shoichiro Takao, Yoichiro Takata, Kosaku Higashino, Masafumi Harada, Koichi Sairyo
STUDY DESIGN: Radiologic analysis using computed tomography. OBJECTIVES: To analyze the degenerative changes of the facet joints in patients with spondylolysis in comparison with control subjects. SUMMARY OF BACKGROUND DATA: Defects of the pars interarticularis are thought to result in a reduction of biomechanical stress on adjacent facet joints. Therefore, degenerative changes of the facet joints in patients with spondylolysis are expected to be less than those in patients without spondylolysis...
July 2017: Clinical Spine Surgery
Hideyuki Arima, Yoshiji Suzuki, Daisuke Togawa, Yuki Mihara, Hideyuki Murata, Yukihiro Matsuyama
PURPOSE: This study aimed to investigate the treatment effects of low-intensity pulsed ultrasound (LIPUS) on progressive-stage spondylolysis. Spondylolysis is a stress fracture of the pars interarticularis. Based on the results of computed tomography, spondylolysis was classified into three categories: early, progressive, and terminal. Bone healing was prolonged or not obtained in progressive-stage spondylolysis. The progression of spondylolysis to nonunion has been associated with an increased incidence of spondylolisthesis...
December 2017: European Spine Journal
Kazuta Yamashita, Kosaku Higashino, Toshinori Sakai, Yoichiro Takata, Fumio Hayashi, Fumitake Tezuka, Masatoshi Morimoto, Akihiro Nagamachi, Koichi Sairyo
Presently, lumbar spondylolisthesis did not have the indication of direct repair surgery because of the difficulty to reduce the slippage. In this report, we presented a case and described a minimally invasive direct repair surgery to reduce and repair the pars interarticularis defects of lumbar spondylolisthesis. First, curettage and removal of the synovium of the pars interarticularis and decompression of nerve root are conducted. Next, cancellous bone is harvested from the iliac crest. And then the Percutaneous Pedicle Screws are inserted bilaterally...
2017: Journal of Medical Investigation: JMI
Hideto Kaneko, Mototsune Murakami, Kazuya Nishizawa
BACKGROUND: Stress injuries (stress fractures and stress reactions) of the lumbosacral region are one of the causes of sports-related lower back pain in young individuals. These injuries can be detected by bone marrow edema lesion on MRI. However, little is known about the prevalence and clinical features of early stage lumbosacral stress injuries. This study aimed to evaluate the epidemiology of lumbosacral stress injuries. METHODS: A total of 312 patients (under 18 years of age) who complained of sports-related lower back pain that had lasted for ≥7 days underwent magnetic resonance imaging (MRI) scans...
May 2017: Archives of Orthopaedic and Trauma Surgery
Fumitake Tezuka, Koichi Sairyo, Toshinori Sakai, Akira Dezawa
STUDY DESIGN: This study was a case series. OBJECTIVE: The purpose of this paper was 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 1 case series written in English reporting on adult-onset fresh spondylolysis...
April 2017: Clinical Spine Surgery
Masahiro Morita, Akira Miyauchi, Shinya Okuda, Takenori Oda, Motoki Iwasaki
STUDY DESIGN: A case series study. OBJECTIVE: To investigate the electrophysiological location of nerve root entrapment in patients with isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA: Although the lesion of the nerve root in patients with isthmic spondylolisthesis has been thought to be located at the pars interarticularis due to proliferation of fibrous cartilage, there is no electrophysiological study in relation to this accomplished fact...
April 2017: Clinical Spine Surgery
Ribhu T Jha, Hasan R Syed, Michael Catalino, Faheem A Sandhu
BACKGROUND: Upper lumbar disc herniations comprise only 1%-2% of all lumbar disc herniations. Patients exhibit nonspecific signs and symptoms in comparison to predictable radiculopathies, as seen in lower lumbar disc herniations. The unique anatomic characteristics of the upper lumbar spine present several challenges for safe and effective surgical treatment of disc herniations. The authors review the anatomy of the upper lumbar spine, describe a novel approach to upper lumbar disc herniations, and present 3 cases with a focus on clinical outcome and technical pearls...
April 2017: World Neurosurgery
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