Spondylolytic spondylolisthesis: various imaging features and natural courses

Abstract

with spondylolysis and the other with degeneration of facet joints and/or intervertebral disc. Many patients with spondylolysis remain asymptomatic and certain cases become symptomatic, with low back pain and, less commonly, radicular pain. Spondylolisthesis can also be asymptomatic, but may cause low back pain, spinal instability, and radiculopathy, which requires conservative and/or surgical treatment.The incidence of lumbar spondylolysis has been reported to be 8 % in the adult population [2], and it was variable among races and sexes. Sakai et al. [3] reported that the prevalence of lumbar spondylolysis among the Japanese population between 20 and 29 years of age, found by multidetector CT, was 5.9 %, with a male to female ratio of 2:1. Spondylolysis has never been seen in newborn babies: it is seen only after walking. The upright posture and bipedal position play a role in the development of spondylolysis [4]. The prevalence of lumbar spondylolisthesis was reported to be 20.7 % in the adult population, and spondylolysis without spondylolisthesis was relatively uncommon and was only seen at the lower lumbar level [5].Although bone defects of typical isthmic spondylolysis run obliquely through the pars interarticularis, and are well depicted on oblique lumbar radiography, atypical isthmic defects have been reported in several papers [6,7]. The pathomechanism and incidence of atypical isthmic defects is not well known, and the radiographic appearance of atypical isthmic spondylolysis has not been well recognized among radiologists. Other atypical spondylolyses included various types, and two variations have been reported in the literature [8][9][10]. Unilateral spondylolysis accounts for 3-33 % of all cases of spondylolysis and has been estimated to be approximately 3-7 % of the general population [11]. It may be associated with certain athletic activities, such as cricket, ballet, and gymnastics, and the association with Abstract The purpose of this paper is to review typical and atypical imaging features of spondylolytic spondyolisthesis and natural courses. Imaging features of the typical pars defect in early phase include bone marrow edema of the isthmus on MR imaging with progression of bone defect on plain radiography or CT. There are various defect types (pedicular cleft, retroisthmic cleft) and locations (upper lumbar spine and unilateral lesions). Natural courses also vary, with different patterns of progression and stabilization. Clinical correlation of the imaging and clinical features is often difficult.

Facet Joints of the Spine: Structure–Function Relationships, Problems and Treatments, and the Potential for Regeneration

“…Degenerative spondylolisthesis (Figure 2c) occurs in ∼14% of adults (95), whereas scoliosis affects 2-32% of adults (96,97) and 60% of the elderly population (11). Although the involvement of facet pathology in degenerative spondylolisthesis and scoliosis is not fully understood, facet degeneration and its contribution to spinal instability are thought to be associated with these conditions (96,(98)(99)(100)(101). Additional studies to understand facet joint structure-function relationships may further elucidate our understanding of the facet's role in these conditions.…”

The Incidence of Pars Interarticularis Defects in Athletes

“…10,11 Neurological signs are rare, occurring only if nerve root compression has developed. 6,12 Spondylolysis is most commonly bilateral 13 (Figure 3), possibly because unilateral spondylolysis increases stress on the contralateral pedicle. 14 The majority of spondylolysis occurs in L5, followed by L4, then combined L4-L5 involvement ( Table 1).…”

Getting published in Radiology: A Deputy Editor’s perspective

“…We hope this article will help prospective authors in Japan and stimulate motivation to conduct and publish high-quality original research studies. We note that the Japanese Journal of Radiology is an emerging journal that publishes original research articles and review papers [12], with an impact factor increasing year by year, and we sincerely hope this positive trend continues [13]. We also hope that this article will serve as a bridge between the two journals Radiology and Japanese Journal of Radiology.…”