Union of defects in the pars interarticularis of the lumbar spine in children and adolescents

Fujii, Kouji; Katoh, Shinsuke; Sairyo, Koichi; Ikata, Takaaki; Yasui, Natsuo

doi:10.1302/0301-620x.86b2.14339

Cited by 175 publications

(142 citation statements)

References 32 publications

(34 reference statements)

Supporting

Mentioning

122

Contrasting

Unclassified

Order By: Relevance

“…Acute lesions, with signs of active healing or minimal separation, heal at a greater rate than chronic lesions with separation or pseudarthrosis. 5,19,33,38,42 Because of enhanced healing potential, physicians typically treat acute spondylolysis with a more conservative course of care.…”

Section: 28mentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Clinical Outcomes and Factors That Predict Poor Prognosis in Athletes After a Diagnosis of Acute Spondylolysis: A Retrospective Review With Telephone Follow-up

Selhorst¹,

Fischer²,

Graft³

et al. 2016

Journal of Orthopaedic & Sports Physical Therapy

View full text Add to dashboard Cite

® T t STUDY DESIGN:Retrospective review with telephone follow-up. T t BACKGROUND:Acute spondylolytic injuries have a dramatic impact on the young athlete. Excellent short-term clinical outcomes have been observed, but not enough is known about longterm clinical outcomes. T t OBJECTIVES:(1) To report long-term clinical outcomes for patients diagnosed with acute spondylolysis, and (2) to assess the prognostic ability of retrospective variables for long-term outcomes. T t METHODS: Patients from 2010 through 2013were retrospectively reviewed to identify patients and to obtain demographic, baseline, and shortterm outcomes. Long-term follow-up data were collected by telephone from patients diagnosed with acute spondylolysis to assess recurrence rate of low back pain, perceived outcome, pain, and functional ability. Patients were categorized as having a good or poor long-term outcome based on these measures. Logistic regression analysis was performed to assess the prognostic ability of the retrospective variables for long-term outcomes 3.4 years (range, 1.5-5.6 years) after treatment. T t RESULTS:One hundred twenty-one (71.6%) patients completed the follow-up questionnaire (48 female; mean age at baseline, 14.4 years). At follow-up, 81 (66.9%) patients were able to maintain their same or a higher level of sport. Recurrence of significant symptoms was reported by 55 (45.5%) patients, with 41 (33.9%) requiring medical treatment. The final logistic regression model revealed that female sex, adverse reaction during care, and multilevel injury were significant predictors of poor long-term outcome (R 2 = 0.22).

show abstract

Section: 28mentioning

confidence: 99%

“…16,19,26 Clinical outcomes should take precedence over radiographic outcomes, as radiographic outcomes do not predict the patient's quality of life. 26 Few studies, however, have looked at factors associated with long-term clinical prognosis.…”

Section: Participantsmentioning

confidence: 99%

Long-Term Clinical Outcomes and Factors That Predict Poor Prognosis in Athletes After a Diagnosis of Acute Spondylolysis: A Retrospective Review With Telephone Follow-up

Selhorst¹,

Fischer²,

Graft³

et al. 2016

Journal of Orthopaedic & Sports Physical Therapy

View full text Add to dashboard Cite

show abstract

“…Healing occurs in some, but not all cases. Fujii et al 58 found that the stage of the defect and the vertebral level involved were the predominant prognostic indicators for union. Early stage defects were much more prone to union than progressive or late stage defects.…”

Section: Conservative Managementmentioning

confidence: 99%

Spondylolysis and spondylolisthesis: a narrative review of etiology, diagnosis, and conservative management

Haun

Kettner

2005

Journal of Chiropractic Medicine

View full text Add to dashboard Cite

show abstract

“…The terminal stage had a wide and round margin and sclerosis. They also noted that a significantly greater proportion of defects achieved union in the early stage compared with progressive and terminal stages, and no bony union was seen in the terminal stage [39].…”

mentioning

confidence: 98%

“…Fujii et al described the fracture of the isthmus as having three stages: early, progressive, and terminal [39]. The early stage showed a narrow fissure through the isthmus with a sharp margin.…”

mentioning

confidence: 99%

Spondylolytic spondylolisthesis: various imaging features and natural courses

Nakayama

Ehara

2014

Jpn J Radiol

View full text Add to dashboard Cite

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.

show abstract

Union of defects in the pars interarticularis of the lumbar spine in children and adolescents

Cited by 175 publications

References 32 publications

Long-Term Clinical Outcomes and Factors That Predict Poor Prognosis in Athletes After a Diagnosis of Acute Spondylolysis: A Retrospective Review With Telephone Follow-up

Long-Term Clinical Outcomes and Factors That Predict Poor Prognosis in Athletes After a Diagnosis of Acute Spondylolysis: A Retrospective Review With Telephone Follow-up

Spondylolysis and spondylolisthesis: a narrative review of etiology, diagnosis, and conservative management

Spondylolytic spondylolisthesis: various imaging features and natural courses

Contact Info

Product

Resources

About