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Lumbar spondylolysis: a review.
Antonio Leone1, Alessandro Cianfoni, Alfonso Cerase
1Department of Bioimaging and Radiological Sciences, Catholic University, School of Medicine, Largo A. Gemelli, 1, 00168, Rome, Italy. a.leonemd@tiscali.it
Skeletal Radiology
|May 5, 2010
Summary
Spondylolysis, a pars interarticularis defect common in adolescent athletes, is best diagnosed using MRI for early stress detection and nerve compression, though CT is accurate for bony defects. This review covers diagnosis and treatment.
Area of Science:
- Orthopedics
- Radiology
- Sports Medicine
Background:
- Spondylolysis is a stress fracture of the pars interarticularis, frequently affecting adolescents, especially athletes.
- It can cause back pain, instability, and radiculopathy, with complex underlying biomechanics.
- Accurate diagnosis is crucial for prognosis and treatment planning.
Purpose of the Study:
- To review current concepts of spondylolysis, including epidemiology and pathogenesis.
- To detail imaging principles for diagnosis and follow-up of spondylolysis.
- To discuss general treatment guidelines for this condition.
Main Methods:
- Review of current literature on spondylolysis diagnosis and management.
- Discussion of various imaging modalities: radiography, CT, MRI, and SPECT.
- Focus on the role of imaging in detecting bony defects, stress responses, and associated pathologies.
Main Results:
- Radiography can show pars defects, while CT is accurate for bony defects and healing assessment.
- MRI is the primary choice for adolescents with suspected stress reactions, detecting early edema and nerve compression.
- SPECT has limited utility due to radiation exposure and accuracy issues.
Conclusions:
- Imaging plays a vital role in spondylolysis diagnosis, distinguishing acute from chronic lesions, and guiding treatment.
- MRI is preferred for initial evaluation in adolescents due to its sensitivity to early stress responses and associated nerve issues.
- A comprehensive understanding of imaging principles is essential for effective patient management.
