The sclerotic pedicle — how many causes are there?

Yochum, TerryR.; Sellers, L. T.; Oppenheimer, D A; Peterson, Catherine; Kirton, C; Mas, E. C. Dal; Anderson, Al

doi:10.1007/bf00241791

Cited by 10 publications

(2 citation statements)

References 24 publications

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“…4,10,21,22,25 Despite the diversity of the causes, the reactive sclerosis is triggered by a stress-changing event in all cases. No doubt, pedicle sclerosis and/or fracture due to unilateral spondylolysis is the most critical condition among all these clinical scenarios.…”

Section: Discussionmentioning

confidence: 99%

Adaptive remodeling at the pedicle due to pars fracture: a finite element analysis study

İnceoğlu

Mageswaran²,

Modic

et al. 2014

SPI

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Object Spondylolysis is a common condition among the general population and a major cause of back pain in young athletes. This condition can be difficult to detect with plain radiography and has been reported to lead to contralateral pars fracture or pedicle fracture in the terminal stages. Interestingly, some patients with late-stage spondylolysis are observed to have radiographic or CT evidence of a sclerotic pedicle on the side contralateral to the spondylolysis. Although computational studies have shown stress elevation in the contralateral pedicle after a pars fracture, it is not known if these changes would cause sclerotic changes in the contralateral pedicle. The objective of this study was to investigate the adaptive remodeling process at the pedicle due to a contralateral spondylolysis using finite element analysis. Methods A multiscale finite element model of a vertebra was obtained by combining a continuum model of the posterior elements with a voxel-based pedicle section. Extension loading conditions were applied with or without a fracture at the contralateral pars to analyze the stresses in the contralateral pedicle. A remodeling algorithm was used to simulate and assess density changes in the contralateral pedicle. Results The remodeling algorithm demonstrated an increase in bone formation around the perimeter of the contralateral pedicle with some localized loss of mass in the region of cancellous bone. Conclusions The authors' results indicated that a pars fracture results in sclerotic changes in the contralateral pedicle. Such a remodeling process could increase overall bone mass. However, focal bone loss in the region of the cancellous bone of the pedicle might predispose the pedicle to microfractures. This phenomenon explains, at least in part, the origin of pedicle stress fractures in the sclerotic contralateral pedicles of patients with unilateral spondylolysis.

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Section: Discussionmentioning

confidence: 99%

Adaptive remodeling at the pedicle due to pars fracture: a finite element analysis study

İnceoğlu

Mageswaran²,

Modic

et al. 2014

SPI

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“…Additionally, increased stress on the normal side causes sclerosis and hypertrophy of this lamina and pedicle [ 7 ]. In the typical isthmic or superior facet defect, this change occurs at the level of the abnormal lamina; in uncommon inferior laminar defects, the hypertrophied pedicle is below the lesion [ 8 ].…”

Section: Spondylolysismentioning

confidence: 99%

The Spine: Acquired Disorders

Wootton‐Gorges¹

2014

Pediatric Orthopedic Imaging

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The chapter begins with the discussion of spondylolysis and spondylolisthesis, including a section describing various methods for imaging these conditions. Intervertebral disc disease follows, with discussion of intervertebral calcifi cation and disc prolapse. Spinal trauma is addressed, along with infl ammatory and neoplastic destructive vertebral lesions. The last section of the chapter covers salient features of tumors that occur in the spine, including osteoid osteoma, osteoblastoma, aneurysmal bone cyst, Langerhans cell histiocytosis, and osteochondroma.The pediatric spine is affected by a variety of processes that are unique to children or that manifest in children in unusual ways. Spondylolysis represents a response to chronic stress injury and may lead to spondylolisthesis, wherein one vertebra slips forward on the subjacent vertebra. Spine fractures in young children differ greatly from those in adults and are especially common in the upper cervical spine. Discitis, an uncommon idiopathic infl ammatory process, is essentially limited to children, whereas disc herniation and spine infection in children resemble these processes in adults. Several bone tumors, such as osteoid osteoma/osteoblastoma, Langerhans cell histiocytosis, and osteochondroma have unique appearances in the spine. (Infl ammatory,

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