The Pathogenesis of Spondylolysis

Bechtel, William; Griffiths, Harry J.; Eisenstadt, R.

doi:10.1097/00004424-198207000-00141

Cited by 3 publications

(4 citation statements)

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“…The prevalence of spondylolysis in adults is about 5%, whereas as many as 50% of adolescent athletes with persistent back pain were found to have spondylolysis (3). The pathogenesis is likely related to shear forces from repetitive hyperextension and trunk rotation during the adolescent growth spurt (4, 5). Consequently, the young population is predominately affected.…”

Section: Introductionmentioning

confidence: 99%

“…3 The pathogenesis is likely related to shear forces from repetitive hyperextension and trunk rotation during the adolescent growth spurt. 4,5 Consequently, the young population is predominately affected. For this reason, exposure to ionizing radiation is a major concern, as they are susceptible to mutagenic radiation and accumulation of radiation exposure throughout the entire life span.…”

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confidence: 99%

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Ultrashort Time-to-Echo Magnetic Resonance Imaging at 3 T for the Detection of Spondylolysis in Cadaveric Spines

et al. 2019

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Ultrashort Time-to-Echo Magnetic Resonance Imaging at 3 T for the Detection of Spondylolysis in Cadaveric Spines

et al. 2019

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“…Image registration: The MRI and CT images were stacked to create individual 3D volumes for each specimen and rescaled to have the same voxel size of (0.625 mm) 3 . Threedimensional rigid body image registration was performed using FMRIB's linear image registration tool (FLIRT) [55] using only translation and rotation.…”

Section: Imaging Datamentioning

confidence: 99%

“…Spondylolysis is defined as a bony defect in the pars interarticularis of the vertebral neural arch of the lumbar spine. In particular, isthmic spondylolysis [ 1 ], characterized by unilateral or bilateral bone stress injury secondary to repetitive mechanical spinal loading during activity [ 2 , 3 ], is found in as many as 50% of adolescent athletes with persistent LBP [ 2 , 4 , 5 , 6 , 7 , 8 , 9 ]. Failure to make the correct diagnosis may lead to a premature return to activities that can be detrimental to the healing of the spondylolysis.…”

Section: Introductionmentioning

confidence: 99%

Deep-Learning-Aided Evaluation of Spondylolysis Imaged with Ultrashort Echo Time Magnetic Resonance Imaging

Achar,

Hwang,

Finkenstaedt

et al. 2023

Sensors

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Isthmic spondylolysis results in fracture of pars interarticularis of the lumbar spine, found in as many as half of adolescent athletes with persistent low back pain. While computed tomography (CT) is the gold standard for the diagnosis of spondylolysis, the use of ionizing radiation near reproductive organs in young subjects is undesirable. While magnetic resonance imaging (MRI) is preferable, it has lowered sensitivity for detecting the condition. Recently, it has been shown that ultrashort echo time (UTE) MRI can provide markedly improved bone contrast compared to conventional MRI. To take UTE MRI further, we developed supervised deep learning tools to generate (1) CT-like images and (2) saliency maps of fracture probability from UTE MRI, using ex vivo preparation of cadaveric spines. We further compared quantitative metrics of the contrast-to-noise ratio (CNR), mean squared error (MSE), peak signal-to-noise ratio (PSNR), and structural similarity index (SSIM) between UTE MRI (inverted to make the appearance similar to CT) and CT and between CT-like images and CT. Qualitative results demonstrated the feasibility of successfully generating CT-like images from UTE MRI to provide easier interpretability for bone fractures thanks to improved image contrast and CNR. Quantitatively, the mean CNR of bone against defect-filled tissue was 35, 97, and 146 for UTE MRI, CT-like, and CT images, respectively, being significantly higher for CT-like than UTE MRI images. For the image similarity metrics using the CT image as the reference, CT-like images provided a significantly lower mean MSE (0.038 vs. 0.0528), higher mean PSNR (28.6 vs. 16.5), and higher SSIM (0.73 vs. 0.68) compared to UTE MRI images. Additionally, the saliency maps enabled quick detection of the location with probable pars fracture by providing visual cues to the reader. This proof-of-concept study is limited to the data from ex vivo samples, and additional work in human subjects with spondylolysis would be necessary to refine the models for clinical use. Nonetheless, this study shows that the utilization of UTE MRI and deep learning tools could be highly useful for the evaluation of isthmic spondylolysis.

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Ultrashort Echo Time and Fast Field Echo Imaging for Spine Bone Imaging with Application in Spondylolysis Evaluation

Vucevic,

Malis,

Yamashita

et al. 2024

Computation

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Isthmic spondylolysis is characterized by a stress injury to the pars interarticularis bones of the lumbar spines and is often missed by conventional magnetic resonance imaging (MRI), necessitating a computed tomography (CT) for accurate diagnosis. We compare MRI techniques suitable for producing CT-like images. Lumbar spines of asymptomatic and low back pain (LBP) subjects were imaged at 3-Tesla with multi-echo ultrashort echo time (UTE) and field echo (FE) sequences followed by simple post-processing of averaging and inverting to depict spinal bones with a CT-like appearance. The contrast-to-noise ratio (CNR) for bone was determined to compare UTE vs. FE and single-echo vs. multi-echo data. Visually, both sequences depicted cortical bone with good contrast; UTE-processed sequences provided a flatter contrast for soft tissues that made them easy to distinguish from bone, while FE-processed images had better resolution and bone–muscle contrast, which are important for fracture detection. Additionally, multi-echo images provided significantly (p = 0.03) greater CNR compared with single-echo images. Using these techniques, progressive spondylolysis was detected in an LBP subject. This study demonstrates the feasibility of using spine bone MRI to yield CT-like contrast. Through the employment of multi-echo UTE and FE sequences combined with simple processing, we observe sufficient enhancements in image quality and contrast to detect pars fractures.

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The Pathogenesis of Spondylolysis

Cited by 3 publications

References 0 publications

Ultrashort Time-to-Echo Magnetic Resonance Imaging at 3 T for the Detection of Spondylolysis in Cadaveric Spines

Ultrashort Time-to-Echo Magnetic Resonance Imaging at 3 T for the Detection of Spondylolysis in Cadaveric Spines

Deep-Learning-Aided Evaluation of Spondylolysis Imaged with Ultrashort Echo Time Magnetic Resonance Imaging

Ultrashort Echo Time and Fast Field Echo Imaging for Spine Bone Imaging with Application in Spondylolysis Evaluation

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