Incidence of Lumbar Spondylolysis in the General Population in Japan Based on Multidetector Computed Tomography Scans From Two Thousand Subjects

Sakai, Toshinori; Sairyo, Koichi; Sugiyama, Takao; Nishitani, Hiromu; Yasui, Natsuo

doi:10.1097/brs.0b013e3181b4abbe

Cited by 166 publications

(168 citation statements)

References 30 publications

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“…Recurrent microtrauma following repetitive hyper-extension and rotational stresses delivered across a relatively hyperlordotic or hypo/dysplastic lumbar spine lead to gradual failure of neural arch [8]. More commonly, these lesions have been described in active labourers [9,10] or adolescent sportspersons who are prone to repeated, chronic injuries [6]. Nevertheless, certain reports have also described [10] single or multilevel insufficiency pedicle fractures in elderly patients in association with severe osteoporosis or renal osteodystrophy.…”

Section: Discussionmentioning

confidence: 96%

“…The surgical options described in literature for such lesions include direct repair of the lytic lesion [2][3][4][5][6][7][8][9][10][11][12][13][14][15], postero-lateral fusion, trans-foraminal or posterior lumbar interbody fusion (single or double level TLIF or PLIF) [10]. In young athletes with chronic pediculolysis without evidence of intervertebral instability, direct repair of the pedicular cleft using compression screws has been described as a treatment option [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Such motion-preserving surgeries may obviate the need for segmental fusion procedures in patients with high physical activity.…”

Section: Introductionmentioning

confidence: 99%

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Symptomatic Unilateral Spondylolysis Associated with Non-Spodylolytic Lateral Clefts in Adults – Guidelines for a Rare Condition

Subramanian¹,

Viswanathan²

2017

MOJS

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Non-spondylolytic lateral clefts of the lumbar neural arch (Laminolysis and Pediculolysis): are rare pathologies, which usually occur consequent to repetitive stress injuries in patients with unilateral spondylolysis. These lesions are different from the usual bilateral spondylolytic defects; and their management depends upon the chronicity and the type of bony defect. We hereby discuss the verdict of current literature on underlying patho-mechanics and ideal management guidelines of these rare lesions. Introduction

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Symptomatic Unilateral Spondylolysis Associated with Non-Spodylolytic Lateral Clefts in Adults – Guidelines for a Rare Condition

Subramanian¹,

Viswanathan²

2017

MOJS

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“…Diagnostic testing will most often begin with radiography. The best angle for viewing the pars interarticularis is the lateral oblique view 8,9 . However, this view may not adequately show early, newly developing spondylolysis.…”

Section: Discussionmentioning

confidence: 99%

Sequential Proximal Adjacent Spondylolysis by Pars Interarticularis Fracture in Elite Soccer Player

Kim

Park

Lee

et al. 2017

Korean J Sports Med

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Pars interarticularis fracture is a common finding in young soccer players with low back pain. Spondylolysis in young adults involves a defect of the pars interarticularis, occurring as a result of repeated hyperextension and rotation. Here, we describe the case of a 26-year-old male elite soccer player who was diagnosed with L3 spondylolysis 2 years previously. He visited Incheon Himchan Hospital again because of low back pain. Radiographs showed consecutive spondylolysis at the L3 and L4 levels. Physicians should be aware that repeated performance of athletic movements, such as those during soccer, might lead to consecutive levels of spondylolysis.

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“…A recent investigation has revealed a 3.7 fold Odd ratio for the presence of SL in individuals with SBO. 21 As yet, it is however unclear if SBO is a predisposition for the development of SL. While SBO is a congenital defect, SL is recognised as being a fatigue fracture with an increased incidence among athletes participating in disciplines requiring repetitive forceful hyperextension, axial loading and rotation.…”

Section: Introductionmentioning

confidence: 99%

Finite element investigation of the effect of a bifid arch on loading of the vertebral isthmus

Quah

Yeoman²,

Cizinauskas³

et al. 2014

The Spine Journal

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The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. Spondylolysis (SL) of the lower lumbar spine is frequently associated with spina bifida occulta (SBO). There has not been any study that has demonstrated biomechanical or genetic predispositions to explain the coexistence of these two pathologies. In axial rotation, the intact vertebral arch allows torsional load to be shared between the facet joints. In SBO, the load cannot be shared across the arch, theoretically increasing the mechanical demand of the vertebral isthmus during combined axial loading and rotation when compared to the normal state. Purpose:To test the hypothesis that fatigue failure limits will be exceeded in the case of a bifid arch, but not in the intact case, when the segment is subjected to complex loading corresponding to normal sporting activities. Study Design:Descriptive Laboratory Study Methods:Finite element models of natural and SBO (L4-S1) including ligaments were loaded axially to 1kN and were combined with axial rotation of 3°. Bilateral stresses, alternating stresses and shear fatigue failure on intact and SBO L5 isthmus were assessed and compared. Results:Under 1kN axial load, the von Mises stresses observed in SBO and in the intact cases were very similar (differences <5MPa) having a maximum at the ventral end of the isthmus that decreases monotonically to the dorsal end. However, under 1kN axial load and rotation, the maximum von Mises stresses observed in the ipsilateral L5 isthmus in the SBO case (31MPa) was much higher than the intact case (24.2MPa) indicating a lack of load sharing across the vertebral arch in SBO.When assessing the equivalent alternating shear stress amplitude, this was found to be 22.6MPa for the SBO case and 13.6 MPa for the intact case. From this it is estimated that shear fatigue failure will occur in less than 70,000 cycles, under repetitive axial load & rotation conditions in the SBO case, while for the intact case, fatigue failure will occur only over 10 million cycles. Conclusion:SBO predisposes spondylolysis by generating increased stresses across the inferior isthmus of the inferior articular process, specifically in combined axial rotation and anteroposterior shear. Clinical Relevance:Athletes with SBO who participate in sports that require repetitive lumbar rotation, hyperextension and/or axial loading are at a higher risk of developing spondylolysis compared to athletes with an intact spine. Key Terms:Spina Bifida Occulta, spondylolysis, finite element analysis, stress fracture, fatigue fracture, lumbar spineWhat is known about the subject: SL of the lower lumbar spine is frequently associated with SBO. A recent investigation has revealed a 3.7 fold Odd ratio for the presence of SL in individuals with SBO. As yet, it is unclear if SBO is a...

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Incidence of Lumbar Spondylolysis in the General Population in Japan Based on Multidetector Computed Tomography Scans From Two Thousand Subjects

Abstract: The incidence of lumbar spondylolysis in the Japanese general population was 5.9% (males: 7.9%, females: 3.9%).

Cited by 166 publications

References 30 publications

Symptomatic Unilateral Spondylolysis Associated with Non-Spodylolytic Lateral Clefts in Adults – Guidelines for a Rare Condition

Symptomatic Unilateral Spondylolysis Associated with Non-Spodylolytic Lateral Clefts in Adults – Guidelines for a Rare Condition

Sequential Proximal Adjacent Spondylolysis by Pars Interarticularis Fracture in Elite Soccer Player

Finite element investigation of the effect of a bifid arch on loading of the vertebral isthmus

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