Contralateral Spondylolysis and Fracture of the Lumbar Pedicle in a Young Athlete

Kessous, Eran; Borsinger, Tracy M.; Rahman, Ayesha M; d’Hemecourt, Pierre A.

doi:10.1097/brs.0000000000002086

Cited by 17 publications

(16 citation statements)

References 43 publications

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“…Современные исследователи, изучая спондилолиз, традиционно придерживаются двух основных теорий его происхождения и развития: врожденной [9,16,17] и приобретенной [18][19][20][21][22]. Основоположником теории о врожденном происхождении принято считать Ф.л.…”

Section: материал и методыunclassified

“…Общепризнано, что частота выявления патологии зависит от совокупности различных факторов: возраста, пола, расы, отягощенной наследственности, спортивной деятельности, тех методов лучевой диагностики, которые были использованы в ходе выполнения исследования [20,[23][24][25][26][27]. Так, И.М.…”

Section: материал и методыunclassified

“…Занятия спортом являются фактором высокой степени риска формирования спондилолиза [8,10,20,31,46]. Основным патогенетическим звеном при этом выступает избыточная нагрузка на межсуставную часть дуги нижнего поясничного позвонка в течение длительного времени, например во время тренировочного процесса, при переразгибании позвоночника, в результате чего там формируется зона патологической перестройки костной ткани в виде ее дефекта («усталостного» перелома) [7,10,19,24,40,47,48].…”

Section: материал и методыunclassified

“…нередко у части больных молодого возраста бессимптомно протекающий спондилолиз диагностируют во время проведения обследования по поводу травм позвоночника, выявляя при этом, например, не только костный дефект дуги позвонка, но и «свежий» перелом противоположной половины дуги этого же позвонка [20] или фрактуры тел поясничных позвонков [23].…”

Section: материал и методыunclassified

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Isolated and Multilevel Spondylolysis (Literature Review)

Скрябин¹

2019

Traumatology and Orthopedics of Russia

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One of the main causes of lumbar spine pain is spondylolysis. The purpose of this review is to present the current state of the problem of diagnosis and treatment isolated and multilevel spondylolysis.Materials and Methods. The review includes 86 publications on the problem of spondylolysis for 2005–2019, obtained from electronic databases: PubMed, Cochrane Library, eLIBRARY, CYBERLENINKA.Results. There is still the only known classification of spondylolysis by P. Niggemann et al, which includes four severity of this pathology — from mild to very severe: A, BI, BII, BIII. The classification is based on the nature of changes in the area of bone defect of the vertebral arch when the patient performs functional tests. In some cases, the pathology can be regarded as a transition between different degrees of severity of type B. The treatment of spondylolysis can be both conservative and operational. The conservative therapy consists of physical activity restriction, physiotherapy, wearing a corset, massage, and pharmacotherapy. The purpose of surgical treatment is the removal of fibrous tissue from the zone of spondylolysis and the achievement in this area the bone fusion via a bone autoplasty and(or) osteosynthesis with different metal frameworks. Reasoned arguments about the need for a combination of conservative and surgical treatment of patients with spondylolysis are also reflected in the publications. Information on multilevel spondylolysis is represented by a small number of articles. only 15 authors described clinical cases of multilevel spondylolysis in a total of 21 patients. Spondylolysis is a high risk factor for the spondylolisthesis formation. Among the various categories of patients suffering from spondylolysis and lumbar spondylolysis spondylolisthesis, pregnant women are of particular interest. Hormonal restructuring and changes in the biomechanics of the spine in women during the gestational period often leads to the appearance or intensification pain syndrome in lumbar spine complicating the pregnancy, and hence a fetus development.Conclusion. Timely diagnosis of spondylolysis and the subsequent development of individual rehabilitation not only improves the quality of life of patients, but in some cases can prevent such a serious pathology as spondylolisthesis.

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Section: материал и методыunclassified

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Isolated and Multilevel Spondylolysis (Literature Review)

Скрябин¹

2019

Traumatology and Orthopedics of Russia

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“…Vertebral pedicle fractures are uncommon. Most cases have been reported in associated with a history of spinal surgery [1][2][3][4], osteopetrosis [5][6][7][8] or strenuous activities [9][10][11]. Unilateral pedicle fracture accompanying isthmic spondylolisthesis is extremely rare [12].…”

Section: Introductionmentioning

confidence: 99%

Unilateral Pedicle Fracture Accompanying Spondylolisthesis and Contralateral Spondylolysis: A Case Report

Liu

Baiketuerxun

Zhang

et al. 2020

Preprint

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Study design Case reportObjective To report a rare case with unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis. Summary of Background Data Unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis is rare. Most are association with major trauma, previous spine surgery, osteopetrosis or stress-related activities.Methods We report a patient with spontaneous pedicle fracture associated with contralateral spondylolysis and spondylolisthesis at the L5 level, complaining severe back pain, radicular lower limb pain and intermittent claudication. The pathophysiological mechanism is discussed, and a review of relevant literature is included.Results This patient was successfully treated by decompression laminectomy with transforaminal lumbar interbody fusion (TLIF) and pedicle screw fixation. To our knowledge, cases like this have rarely been reported in the literature.Conclusions Unilateral pedicle stress fracture in patients with spondylolytic spondylolisthesis is rare. It may be related to redistribution of forces in an unstable neural arch resulting from defect in the contralateral pars interarticularis. Our experience suggests that limited decompression and instrumented fusion surgery led to a successful outcome.

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