High-Grade Slippage of the Lumbar Spine in a Rat Model of Spondylolisthesis

Komatsubara, Shinji; Sairyo, Koichi; Katoh, Shinsuke; Sakamaki, Tadanori; Higashino, Kosaku; Yasui, Natsuo

doi:10.1097/01.brs.0000225974.92243.af

Cited by 12 publications

(2 citation statements)

References 27 publications

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“…These patients do not need to refrain from sporting activities, but the treating surgeon should always be aware of the possibility of a progressive slip. [7][8][9] Recent studies have shown that this occurs through the growth plate rather than the disc, [10][11][12][13][14][15][16][17] particularly in children, because it is principally a disorder of the growth plate. We have previously shown that in 80% of children with an immature skeleton and a spondylolysis the slip increases within two years.…”

Section: Discussionmentioning

confidence: 99%

Conservative treatment of lumbar spondylolysis in childhood and adolescence

Sairyo

Sakai

Yasui

2009

The Journal of Bone and Joint Surgery. British volume

112

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It has been noted that bony union of a pars defect can be achieved in children if they wear a trunk brace. Our aim was to evaluate how the stage of the defect on CT and the presence or absence of high signal change in the adjacent pedicle on T2-weighted MRI were related to bony healing. We treated 23 children conservatively for at least three months. There were 19 boys and four girls with a mean age of 13.5 years (7 to 17). They were asked to refrain from sporting activity and to wear a Damen soft thoracolumbosacral type brace. There were 41 pars defects in 23 patients. These were classified as an early, progressive or terminal stage on CT. The early-stage lesions had a hairline crack in the pars interarticularis, which became a gap in the progressive stage. A terminal-stage defect was equivalent to a pseudarthrosis. On the T2-weighted MR scan the presence or absence of high signal change in the adjacent pedicle was assessed and on this basis the defects were divided into high signal change-positive or -negative. Healing of the defect was assessed by CT. In all, 13 (87%) of the 15 early defects healed. Of 19 progressive defects, only six (32%) healed. None of the seven terminal defects healed. Of the 26 high signal change-positive defects 20 (77%) healed after conservative treatment whereas none of the high signal change-negative defects did so. We concluded that an early-stage defect on CT and high signal change in the adjacent pedicle on a T2-weighted MR scan are useful predictors of bony healing of a pars defect in children after conservative treatment.

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