Spondylolysis: a critical review

Abstract

Aim-To provide an understanding of the current concepts in the natural history, pathophysiology, diagnosis, and treatment of spondylolysis based on the available medical literature. Methods-Articles were selected for review by the following methods: (a) MEDLINE searches with review of abstracts to select relevant articles; (b) review of multiple textbooks considered likely to contain information on spondylolysis; (c) review of references in articles identified by (a) and (b). Over 125 articles were ultimately reviewed fully. Publications were selected for inclusion in this article on the basis of perceived scientific and historical merit, particularly as thought to be relevant to achieving the stated purpose of this review. As no controlled clinical trials were identified, this could not be used as an inclusion criterion. Conclusions-Isthmic spondylolysis is considered to represent a fatigue fracture of the pars interarticularis of the neural arch. There is a relatively high incidence of radiographically identified spondylolysis in the general population, but the vast majority of these lesions probably occur without associated symptoms. Symptomatic pars lesions appear to be particularly a clinical problem in adolescents, especially adolescent athletes. The optimal diagnostic and treatment algorithms are not well identified in the current literature. Multiple imaging studies may have a role in the diagnosis of a pars lesion, and treatment seems likely to require at least relative rest and physical rehabilitation with consideration of bracing or, rarely, surgical intervention depending on the clinical context. (Br J Sports Med 2000;34:415-422)

Lumbar spondylolysis: a life long dynamic condition? A cross sectional survey of 4.151 adults

“…Symptomatic adolescents or patients recruited at spine centres have been the natural focus of investigation, while the distribution of spondylolytic lesions in the general population has received far less attention [27]. The incidence of LS in the newborn is zero [12], while prevalences of LS have been found to be 4.5% in six-year-old school children, increasing to 6% in early adulthood.…”

Lumbarspondylolysis: a review

“…The nonsteroidal anti -inflammatory drugs (NSAIDs) should not be ordinarily used because they slow down the bone growth and healing. If the patient is osteoporotic or osteopenic, alendronate sodium is a pharmacological alternative (6,15). Once pain levels are controlled, pulsed ultrasound and therapeutic isometric contractions of surrounding musculature may be initiated to promote additional blood flow, by increasing collagen, neovascular and myofibroblast production in the injured lesion.…”

“…This is defined as: the complete bilateral fractures of the pars interarticularis resulting in the anterior slippage of the vertebra. Predicting risk factors for progression of the slip to Spondylolisthesis has proven to be difficult (6,8).…”

Influencia de la Extensibilidad Isquiosural en la Morfología Sagital del Raquis e Inclinación Pélvica en Deportistas

“…Una adecuada extensibilidad isquiosural es considerada un importante componente de la condición física saludable y un factor implicado en la salud del raquis. La disminución de la extensibilidad isquiosural se ha relacionado con diversas repercusiones raquídeas (Biering-Sorensen, 1984;Standaert & Herring, 2000), lesiones musculares (Cabry & Shiple, 2000) y alteraciones en el ritmo lumbo-pélvico (Esola et al, 1996). Ferrer (1998) estableció una relación directa entre una extensibilidad isquiosural reducida y determinadas repercusiones en el raquis tóraco-lumbar.…”