scholarly journals Multilevel Direct Repair Surgery for Three-Level Lumbar Spondylolysis

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Tetsu Arai ◽  
Koichi Sairyo ◽  
Isao Shibuya ◽  
Ko Kato ◽  
Akira Dezawa
Keyword(s):  
Computed Tomography ◽  
Low Back Pain ◽  
Back Pain ◽  
Pedicle Screw ◽  
Bony Union ◽  
Low Back ◽  
Screw Head ◽  
Direct Repair ◽  
Lumbar Spondylolysis ◽  
Rod System

A 45-year-old man presented to our clinic requesting evaluation for surgical treatment of chronic low back pain of more than 20 years duration. He was diagnosed with 3-level lumbar spondylolysis at L3–5. Direct repair using the pedicle screw and hook-rod system was conducted for all three levels. After the surgery, his low back pain completely disappeared. Six months later, he felt discomfort and heard a metallic sound as he twisted his trunk. Computed tomography and radiography indicated that the hook head for L3 and the screw head for L4 were interfering with each other, causing the sound. We confirmed bony union at L3 and removed the L3 system. Surgeons should be aware of such complications if direct repair using a pedicle screw and hook-rod system is conducted for multilevel spondylolysis.

scholarly journals Multiple-level lumbar spondylolysis and spondylolisthesis

2015 ◽  
Vol 22 (3) ◽  
pp. 283-287 ◽  
Author(s):  
Xinyu Liu ◽  
Lianlei Wang ◽  
Suomao Yuan ◽  
Yonghao Tian ◽  
Yanping Zheng ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pedicle Screw ◽  
Interbody Fusion ◽  
Japanese Orthopaedic Association ◽  
Pedicle Screw Fixation ◽  
Low Back ◽  
Multiple Level ◽  
Lumbar Spondylolysis ◽  
Pars Interarticularis

OBJECT Lumbar spondylolysis and isthmic spondylolisthesis occur most commonly at only one spinal level. The authors report on 13 cases of lumbar spondylolysis with spondylolisthesis at multiple levels. METHODS During July 2007–March 2012, multiple-level spondylolysis associated with spondylolisthesis was diagnosed in 13 patients (10 male, 3 female) at Qilu Hospital of Shandong University. The mean patient age was 43.5 ± 14.6 years. The duration of low-back pain was 11.7 ± 5.1 months. Spondylolysis occurred at L-2 in 2 patients, L-3 in 4 patients, L-4 in all patients, and L-5 in 5 patients. Spondylolysis occurred at 3 spinal levels in 3 patients and at 2 levels in 10 patients. All patients had spondylolisthesis at 1 or 2 levels. Japanese Orthopaedic Association and visual analog scale scores were used to evaluate preoperative and postoperative neurological function and low-back pain. All patients underwent pedicle screw fixation and interbody fusion or direct pars interarticularis repair. RESULTS Both low-back pain scores improved significantly after surgery (p < 0.05). Postoperative radiographs or CT scans showed satisfactory interbody fusion or pars interarticularis healing. No breakage, dislodging, or loosening of the pedicle screw hardware was observed for any patient. CONCLUSIONS Multiple-level lumbar spondylolysis and spondylolisthesis occurred more often in men. Most multiplelevel lumbar spondylolysis occurred at 2 spinal levels and was associated with sports, trauma, or heavy labor. Multiplelevel lumbar spondylolysis occurred mostly at L3–5; associated spondylolisthesis usually occurred at L-4 and L-5, mostly at L-4. The treatment principle was the same as that for single-level spondylolisthesis.

scholarly journals Familial development of lumbar spondylolysis: a familial case report of 7- and 4-year-old brothers and their father

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110155
Author(s):  
Kinshi Kato ◽  
Michiyuki Hakozaki ◽  
Ryosuke Mashiko ◽  
Shin-ichi Konno
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Vertebra ◽  
Bony Union ◽  
Low Back ◽  
Sports Activity ◽  
Definitive Evidence ◽  
Computed Tomographic ◽  
Lumbar Spondylolysis ◽  
Fifth Lumbar Vertebra

The incidence of lumbar spondylolysis is affected by sex, race, and congenital abnormalities. These differences suggest a genetic component to the etiology of spondylolysis. However, no definitive evidence has been presented regarding the inheritance of lumbar spondylolysis. We report familial cases of lumbar spondylolysis in 7- and 4-year-old brothers and their father, each of whom visited our clinic complaining of low back pain. Spondylolysis in the fifth lumbar vertebra (L5) was identified in both boys and their father from clinical, radiographic, computed tomographic, and magnetic resonance imaging examinations. Conservative treatment was provided for both boys. No bony union of any spondylolytic lesions was obtained, but they returned to sports activity without low back pain. Frequent development of spondylolysis, even at younger ages, in all male family members might indicate an underlying genetic etiology in lumbar spondylolysis, primarily in the form of autosomal dominant inheritance. However, information on patients and their parents should be considered carefully, as bony union with conservative therapy is not expected in such patients.

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 12: Pedicle screw fixation as an adjunct to posterolateral fusion

2014 ◽  
Vol 21 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Michael W. Groff ◽  
Andrew T. Dailey ◽  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
William C. Watters ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcome ◽  
Pedicle Screw ◽  
Chronic Low Back Pain ◽  
Screw Fixation ◽  
Lumbar Fusion ◽  
Pedicle Screw Fixation ◽  
Controlled Study ◽  
Low Back

The utilization of pedicle screw fixation as an adjunct to posterolateral lumbar fusion (PLF) has become routine, but demonstration of a definitive benefit remains problematic. The medical evidence indicates that the addition of pedicle screw fixation to PLF increases fusion rates when assessed with dynamic radiographs. More recent evidence, since publication of the 2005 Lumbar Fusion Guidelines, suggests a stronger association between radiographic fusion and clinical outcome, although, even now, no clear correlation has been demonstrated. Although several reports suggest that clinical outcomes are improved with the addition of pedicle screw fixation, there are conflicting findings from similarly classified evidence. Furthermore, the largest contemporary, randomized, controlled study on this topic failed to demonstrate a significant clinical benefit with the use of pedicle screw fixation in patients undergoing PLF for chronic low-back pain. This absence of proof should not, however, be interpreted as proof of absence. Several limitations continue to compromise these investigations. For example, in the majority of studies the sample size is insufficient to detect small increments in clinical outcome that may be observed with pedicle screw fixation. Therefore, no definitive statement regarding the efficacy of pedicle screw fixation as a means to improve functional outcomes in patients undergoing PLF for chronic low-back pain can be made. There appears to be consistent evidence suggesting that pedicle screw fixation increases the costs and complication rate of PLF. High-risk patients, including (but not limited to) patients who smoke, patients who are undergoing revision surgery, or patients who suffer from medical conditions that may compromise fusion potential, may appreciate a greater benefit with supplemental pedicle screw fixation. It is recommended, therefore, that the use of pedicle screw fixation as a supplement to PLF be reserved for those patients in whom there is an increased risk of nonunion when treated with only PLF.

The Ability of Computed Tomography to Identify a Painful Zygapophysial Joint in Patients With Chronic Low Back Pain

Spine ◽  
1995 ◽  
Vol 20 (8) ◽  
pp. 907-912 ◽  
Author(s):  
Anthony C. Schwarzer ◽  
Shih-chang Wang ◽  
Diarmuid OʼDriscoll ◽  
Timothy Harrington ◽  
Nikolai Bogduk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Zygapophysial Joint

Hybrid imaging (SPECT/computed tomography) with three-dimensional reconstruction: a new diagnostic tool for the study of low back pain after spinal fusion surgery

2015 ◽  
Vol 15 (2) ◽  
pp. 377-378 ◽  
Author(s):  
Estefania López Rodriguez ◽  
Rosario Garcia Jimenez ◽  
Marta Sanchez Aguilar ◽  
Julio Valencia Anguita ◽  
Javier Luis Simon
Keyword(s):  
Computed Tomography ◽  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Tool ◽  
Hybrid Imaging ◽  
Three Dimensional ◽  
Low Back ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Dimensional Reconstruction

scholarly journals Increased sagittal diameter of the vertebral arch aids in diagnosis of lumbar spondylolysis

2020 ◽  
Author(s):  
Shi-Zheng Chen ◽  
An-Ni Tong ◽  
He-Hu Tang ◽  
Zhen Lv ◽  
Shu-Jia Liu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Control Group ◽  
Low Back ◽  
Isthmic Spondylolisthesis ◽  
X Ray ◽  
Lumbar Spondylolysis ◽  
Significant Difference ◽  
Pars Interarticularis ◽  
Vertebral Arch

Abstract Objective To identify a diagnostic indicator of lumbar spondylolysis visible in plain X-ray films. Methods One hundred and seventy-two patients with low back pain who received X-ray and computerized tomography (CT) examinations were identified and studied. They were divided into three groups: the spondylosis without spondylolisthesis (SWS) group, comprising 67 patients with bilateral pars interarticularis defects at L5 and without spondylolisthesis, the isthmic spondylolisthesis (IS) group, comprising 74 patients with L5/S1 spondylolisthesis and bilateral L5 pars interarticularis defects, and the control group, comprising 31 patients with low back pain but without spondylolysis. The sagittal diameters of the vertebral arch (SDVAs) of L4 and L5 were measured in lateral X-ray image, and the differences in SDVA between L4 and L5 (DSL4-5) in each case were calculated and analyzed. Results There were no significant differences in demographic characteristics among the three groups. In the SWS and IS groups, the SDVA of L5 was significantly longer than the SDVA of L4 (p < 0.001), whereas no significant difference found in the control group (p > 0.05). DSL4-5, in which the SDVA of L4 was subtracted from the SDVA of L5, significantly differed among the three groups (p < 0.001), and the normal threshold was provisionally determined to be 1.55 mm. Conclusions In bilateral L5 spondylolysis, the SDVA of L5 is wider than the SDVA of L4, and this difference is greater in isthmic spondylolisthesis. This sign in lateral X-rays may provide a simple and convenient aid for the diagnosis of spondylolysis.

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