scholarly journals Factors associated with failure of bony union after conservative treatment of acute cases of unilateral lumbar spondylolysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Masaki Tatsumura ◽  
Hisanori Gamada ◽  
Shun Okuwaki ◽  
Fumihiko Eto ◽  
Katsuya Nagashima ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Conservative Treatment ◽  
Bone Marrow Edema ◽  
Conservative Therapy ◽  
Bony Union ◽  
Pathological Stage ◽  
Factors Associated ◽  
Lumbar Spondylolysis ◽  
Lesion Level ◽  
Marrow Edema

Abstract Background If bone union is expected, conservative treatment is generally selected for lumbar spondylolysis. However, sometimes conservative treatments are unsuccessful. We sought to determine the factors associated with failure of bony union in acute unilateral lumbar spondylolysis with bone marrow edema including contralateral pseudarthrosis. Methods This study targeted unilateral lumbar spondylolysis treated conservatively in high school or younger students. Conservative therapy was continued until the bone marrow edema disappeared on MRI and bone union was investigated by CT. We conducted a univariate analysis of sex, age, pathological stage, lesion level complicating the contralateral bone defect, lesion level, and intercurrent spina bifida occulta, and variables with p < 0.1 were considered in a logistic regression analysis. An item with p < 0.05 was defined as a factor associated with failure of bony union. Results We found 92 cases of unilateral spondylolysis with bone marrow edema and 66 cases were successfully treated conservatively. Failure of bony union in unilateral lumbar spondylolysis with bone marrow edema was associated with progressive pathological stage (p = 0.004), contralateral pseudarthrosis (p < 0.001), and L5 lesion level (p = 0.002). The odds ratio was 20.0 (95% CI 3.0–193.9) for progressive pathological stage, 78.8 (95% CI 13–846) for contralateral pseudarthrosis, and 175 (95% CI 8.5–8192) for L5 lesion level. Conclusions Conservative therapy aiming at bony union is contraindicated in cases of acute unilateral spondylolysis when the pathological stage is progressive, the lesion level is L5, or there is contralateral pseudarthrotic spondylolysis.

scholarly journals Factors associated with failure of bony union after conservative treatment of acute cases of unilateral lumbar spondylolysis

2021 ◽  
Author(s):  
Masaki Tatsumura ◽  
Hisanori Gamada ◽  
Shun Okuwaki ◽  
Fumihiko Eto ◽  
Katsuya Nagashima ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Conservative Therapy ◽  
Bony Union ◽  
Pathological Stage ◽  
Factors Associated ◽  
Lumbar Spondylolysis ◽  
Lesion Level ◽  
Advanced Pathological Stage ◽  
Marrow Edema

Abstract Background: If bone union is expected, conservative treatment is generally selected for lumbar spondylolysis. However, sometimes conservative treatments are unsuccessful. We sought to determine the factors associated with failure of bony union in acute unilateral lumbar spondylolysis with bone marrow edema including contralateral pseudoarthrosis.Methods: This study targeted unilateral lumbar spondylolysis treated conservatively in high school or younger students. Conservative therapy was continued until the bone marrow edema disappeared on MRI and bone union was investigated by CT. We conducted a univariate analysis of sex, age, pathological stage, lesion level complicating the contralateral bone defect, lesion level, and intercurrent spina bifida occulta, and variables with p < 0.1 were considered in a logistic regression analysis. An item with p < 0.05 was defined as a factor associated with failure of bony union.Results: We found 92 cases of unilateral spondylolysis with bone marrow edema and 66 cases were successfully treated conservatively. Failure of bony union in unilateral lumbar spondylolysis with bone marrow edema was associated with advanced pathological stage (p = 0.004), contralateral pseudoarthrosis (p < 0.001), and L5 lesion level (p = 0.002). The odds ratio was 20.0 (95% CI 3.0–193.9) for advanced pathological stage, 78.8 (95% CI 13–846) for contralateral pseudoarthrosis, and 175 (95% CI 8.5–8192) for L5 lesion level.Conclusions: Conservative therapy aiming at bony union is contraindicated in cases of acute unilateral spondylolysis when the pathological stage is advanced, the lesion level is L5, or there is contralateral pseudoarthrotic spondylolysis.

scholarly journals Factors Associated with Failure of Bony Union After Conservative Treatment of Acute Cases of Unilateral Lumbar Spondylolysis

2020 ◽  
Author(s):  
Masaki Tatsumura ◽  
Hisanori Gamada ◽  
Shun Okuwaki ◽  
Fumihiko Eto ◽  
Katsuya Nagashima ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Conservative Therapy ◽  
Bony Union ◽  
Pathological Stage ◽  
Factors Associated ◽  
Lumbar Spondylolysis ◽  
Lesion Level ◽  
Advanced Pathological Stage ◽  
Marrow Edema

Abstract Background: If bone union is expected, conservative treatment is generally selected for lumbar spondylolysis. However, sometimes conservative treatments are unsuccessful. We sought to determine the factors associated with failure of bony union in acute unilateral lumbar spondylolysis with bone marrow edema including contralateral pseudoarthrosis.Methods: This study targeted unilateral lumbar spondylolysis treated conservatively in high school or younger students. Conservative therapy was continued until the bone marrow edema disappeared on MRI and bone union was investigated by CT. We conducted a univariate analysis of sex, age, pathological stage, lesion level complicating the contralateral bone defect, lesion level, and intercurrent spina bifida occulta, and variables with p < 0.1 were considered in a logistic regression analysis. An item with p < 0.05 was defined as a factor associated with failure of bony union.Results: We found 92 cases of unilateral spondylolysis with bone marrow edema and 66 cases were successfully treated conservatively. Failure of bony union in unilateral lumbar spondylolysis with bone marrow edema was associated with advanced pathological stage (p = 0.004), contralateral pseudoarthrosis (p < 0.001), and L5 lesion level (p = 0.002). The odds ratio was 20.0 (95% CI 3.0–193.9) for advanced pathological stage, 78.8 (95% CI 13–846) for contralateral pseudoarthrosis, and 175 (95% CI 8.5–8192) for L5 lesion level.Conclusions: Conservative therapy aiming at bony union is contraindicated in cases of acute unilateral spondylolysis when the pathological stage is advanced, the lesion level is L5, or there is contralateral pseudoarthrotic spondylolysis.

scholarly journals Factors associated with failure of bony union after conservative treatment of acute cases of unilateral lumbar spondylolysis

2020 ◽  
Author(s):  
Masaki Tatsumura ◽  
Hisanori Gamada ◽  
Shun Okuwaki ◽  
Fumihiko Eto ◽  
Katsuya Nagashima ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Conservative Therapy ◽  
Bony Union ◽  
Pathological Stage ◽  
Factors Associated ◽  
Lumbar Spondylolysis ◽  
Lesion Level ◽  
Advanced Pathological Stage ◽  
Marrow Edema

Abstract Background: If bone union is expected, conservative treatment is generally selected for lumbar spondylolysis. However, sometimes conservative treatments are unsuccessful. We sought to determine the factors associated with failure of bony union in acute unilateral lumbar spondylolysis with bone marrow edema including contralateral pseudoarthrosis.Methods: This study targeted unilateral lumbar spondylolysis treated conservatively in high school or younger students. Conservative therapy was continued until the bone marrow edema disappeared on MRI and bone union was investigated by CT. We conducted a univariate analysis of sex, age, pathological stage, lesion level complicating the contralateral bone defect, lesion level, and intercurrent spina bifida occulta, and variables with p < 0.1 were considered in a logistic regression analysis. An item with p < 0.05 was defined as a factor associated with failure of bony union.Results: We found 92 cases of unilateral spondylolysis with bone marrow edema and 66 cases were successfully treated conservatively. Failure of bony union in unilateral lumbar spondylolysis with bone marrow edema was associated with advanced pathological stage (p = 0.004), contralateral pseudoarthrosis (p < 0.001), and L5 lesion level (p = 0.002). The odds ratio was 20.0 (95% CI 3.0–193.9) for advanced pathological stage, 78.8 (95% CI 13–846) for contralateral pseudoarthrosis, and 175 (95% CI 8.5–8192) for L5 lesion level.Conclusions: Conservative therapy aiming at bony union is contraindicated in cases of acute unilateral spondylolysis when the pathological stage is advanced, the lesion level is L5, or there is contralateral pseudoarthrotic spondylolysis.

scholarly journals Characteristics of Recurrent Cases after Conservative Therapy in Adolescent Lumbar Spondylolysis

2021 ◽  
Author(s):  
Masaki Tatsumura ◽  
Hisanori Gamada ◽  
Shun Okuwaki ◽  
Fumihiko Eto ◽  
Katsuya Nagashima ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Initial Treatment ◽  
Conservative Therapy ◽  
Bony Union ◽  
Average Period ◽  
Sports Activity ◽  
Retrospective Survey ◽  
Time To Recurrence ◽  
Lumbar Spondylolysis ◽  
Unilateral Involvement

Abstract Purpose: Occasionally lumbar spondylolysis in adolescents will recur after conservative treatment. The goal of this study was to retrospectively review the conditions in which recurrence transpired in a subset of adolescent patients diagnosed with acute lumbar spondylolysis. Subjects: A retrospective survey was conducted in 152 patients who had been treated for spondylolysis and had obtained bone union. Twenty subjects were selected who had recurrent lumbar spondylolysis after returning to sports activity following the first spondylolysis treatment. There were 18 males and two females with an average age at the time of initial consultation of 13.3 years and 14.1 years at the time of recurrence.Results: The average period of initial treatment was 101 days, and the average time to recurrence after healing was 149 days. There were three cases at L3, two cases at L4 and 15 cases at L5. At recurrence, 18 patients had unilateral involvement and two patients presented with bilateral occurrence. Four cases did not achieve bony union.Discussion: In this study, the recurrence rate was 13.2%. Eighty percent of cases had recurrence within six months after healing. After recurrence, 20% of the cases reached pseudoarthrosis. It is useful to take regular MRI images to detect recurrence within six months after returning to sports.

Bone marrow edema in the foot—MRI findings after conservative therapy

2005 ◽  
Vol 11 (2) ◽  
pp. 87-91 ◽  
Author(s):  
N. Aigner ◽  
C. Radda ◽  
R. Meizer ◽  
G. Petje ◽  
S. Kotsaris ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Conservative Therapy ◽  
Mri Findings ◽  
Marrow Edema

Cortical and trabecular alterations in patients with bone marrow edema of the lower limb

2013 ◽  
Author(s):  
Afrodite Zendeli ◽  
Christian Muschitz ◽  
Roland Kocijan ◽  
Lukas Fischer ◽  
Daniela Suess ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Lower Limb ◽  
Bone Marrow Edema ◽  
Marrow Edema

Calcium-Suppressed Technique in Dual-Layer Detector Computed Tomography to Evaluate Knee Articular Cartilage

2020 ◽  
Vol 16 ◽  
Author(s):  
Qinglin Meng ◽  
Mengqi Liu ◽  
Weiwei Deng ◽  
Ke Chen ◽  
Botao Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Marrow ◽  
Articular Cartilage ◽  
Bone Marrow Edema ◽  
Knee Joints ◽  
Infrapatellar Fat Pad ◽  
Proton Density ◽  
Knee Cartilage ◽  
Significant Difference ◽  
Marrow Edema

Background: Calcium-suppressed (CaSupp) technique involving spectral-based images has been used to observe bone marrow edema by removing calcium components from the image. Objective: This study aimed to evaluate the knee articular cartilage using the CaSupp technique in dual-layer detector computed tomography (DLCT). Methods: Twenty-eight healthy participants and two patients with osteoarthritis were enrolled, who underwent DLCT and magnetic resonance imaging (MRI) examination. CaSupp images were reconstructed from spectral-based images using a calcium suppression algorithm and were overlaid conventional CT images for visual evaluation. The morphology of the knee cartilage was evaluated, and the thickness of the articular cartilage was measured on sagittal proton density– weighted and CaSupp images in the patellofemoral compartment. Results: No abnormal signal or density, cartilage defect, and subjacent bone ulceration were observed in the lateral and medial femorotibial compartments and the patellofemoral compartment on MRI images and CaSupp images for the 48 normal knee joints. CaSupp images could clearly identify cartilage thinning, defect, subjacent bone marrow edema, and edema of the infrapatellar fat pad in the same way as MRI images in the three knee joints with osteoarthritis. A significant difference was found in the mean thickness of the patellar cartilage between MRI images and CaSupp images, while the femoral cartilage presented no significant difference in thickness between MRI images and CaSupp images over all 48 knee joints. Conclusion: The present study demonstrated that CaSupp images could effectively be used to perform the visual and quantitative assessment of knee cartilage.

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