Development of spondylolytic olisthesis in adolescents

Three dimensional finite element analysis of the pediatric lumbar spine. Part II: biomechanical change as the initiating factor for pediatric isthmic spondylolisthesis at the growth plate

“…His theory was further supported by MRI findings of pediatric patients with isthmic spondylolisthesis [8]. Similar conclusions were reached by Sairyo and coworkers [9,15,16,17,19,20]. They concluded from these series of investigations that the isthmic olisthesis in children and adolescents occurred based on epiphyseal separation: and proposed that pediatric isthmic spondylolisthesis is a physis stress fracture of the vertebral body.…”

“…the vertebral slippage after the epiphyseal separation [3]. The theory seems reasonable because the slippage is most prevalent in children and adolescents [2,4,12,16,21,22]. Also, in the pediatric immature spine, our previous studies revealed that the growth plate at the vertebral body was the weakest-link against anterior shear force [9,11,15].…”

“…In general the percent slippage is not severe; only one-fourth of the vertebrae show more than 25% slippage. The progression from the spondylolysis to the spondylolisthesis generally occurs during adolescent growth periods, and is very rare thereafter [2,4,12,16,21,22]. However, the pathomechanism of its prevalence in the growth period is still unclear.…”

Three-dimensional finite element analysis of the pediatric lumbar spine. Part I: pathomechanism of apophyseal bony ring fracture

“…The pediatric immature spine can be in two stages depending on if the apophyseal ring is cartilaginous or ossified [11]. In this study, our focus is on the etiology of the apophyseal bony ring fracture; hence we considered the apophyseal ring to be ossified.…”

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

“…5,37,42,43 Recent studies elucidate that epiphyseal injury in the juvenile spine is a determining factor for progression and a cause for abnormal morphology. [42][43][44][45] Sairyo et al 46 proposed, using a rat model of lumbar spine slippage, that vertebral forward slippage in the immature spine due to separation of the epiphysis and is unrelated to disc degeneration. Inoue and colleagues 47 have concluded that slips with deformities of the sacral table most likely had developed in adolescence, while slips without deformity likely developed during adulthood.…”