No abstract available.
Spondylolysis*

PURPOSE: We analyzed angles of defect planes of spondylolysis from coronal plane using axial computed tomography to identify the problem of 45degrees oblique plain radiograph by which we routinely has used and to suggest an appropriate radiological diagnostic tool for spondylolysis. MATERIALS AND METHODS: From January 2001 to July 2002, 84 cases of spondylolysis from 44 patients were studied. The diagnosis of spondylolysis was confirmed with axial computed tomography in all cases and angles of isthmic defect from coronal plane were measured. We intended to assess the distribution of angles of isthmic defect and analyzed the result of plain radiographs which were obtained in the direction parallel to the angle of the mean value. RESULTS: Although angles of lumbar isthmic defects have a wide distribution, the mean value was 20.9+/- 9.5degrees which was nearer to coronal plane than 45degrees oblique plane. Fifty eight cases were distributed within 23degrees from coronal plane. A diagnostic sensitivities were 88.1% in lateral view, 78.6% in 45degrees oblique view and 100% in 20degrees oblique view, so a 20degrees oblique view seemed to be more sensitive in diagnosis of lumbar isthmic defect. CONCLUSION: Because the mean angle of lumbar isthmic defects from coronal plane was about 21degrees, obliqueview with 20degrees was more appropriate and sensitive diagnostic tool for spondylolysis than oblique view with 45degrees which have been used routinely.
Diagnosis ; Humans ; Spondylolysis

No abstract available.
Axis, Cervical Vertebra* ; Spondylolysis*

Multiple spondylolytic spondylolisthesis is very uncommon, and surgical reports are also scarce. This study describes the clinical characteristics, radiologic findings and surgical methods in 18 cases of multiple spondylolytic spondylolisthesis encountered by the authors between January, 1993 and December, 1996. Two hundred and thirty spondylolytic spondylolisthesis patients underwent surgery at this hospital during the same period, and in 18 of these, the spondylolysis was multiple, an incidence of 7.8%. There were 16 cases of two level spondylolyses, 15 of which were at L4+L5, and one case at the L3+L4 level, as well as two cases of three level spondylolyses, one at L2+L3+L4 and the other at the L3+L4+L5 level. All 18 cases showed spondylolisthesis at L4/5 and two showed two-level spondylolisthesis at L4/5 and L5/S1. A decompressive laminectomy(Gill operation) was performed in all cases and in addition, two level 360degreesfixation with pedicle screws and PLIF with cages was applied in 16 cases, and two level PLIF with cages in the other two. All showed good post-operative results. In conclusion, the condition was more common in females and bilateral L4 and L5 pars interarticularis defect and L4/5 spondylolisthesis were more common. Decompressive laminectomy(Gill operation) and two level 360degreesfixation with pedicle screws and PLIF with cages was found to be an effective operative choice.
Female ; Humans ; Incidence ; Spondylolisthesis* ; Spondylolysis

OBJECTIVE: The authors introduce a technique of direct repair of pars defects in symptomatic lumbar spondylolysis using pedicle screws and universal hooks. METHODS: From March 2001 to September 2001, six patients with symptomatic lumbar spondylolysis and positive pars injection test underwent this procedure. Patients with lumbar instability and discogenic pain were excluded. After posterior midline incision, clearing of fibrous, cartilaginous and sclerotic tissues in and around the defects of pars was done until healthy bone was exposed. Strips of cancellous bone were taken from adjacent laminae and packed into the defects of pars. After insertion of the pedicle screws, universal hooks were placed in the lower margin of the lamina of the involved vertebra. With gentle compression between the head of screw and universal hook, the nut was fixed. Same procedures were done on the contralateral side. RESULTS: Postoperatively, all six patients experienced clinical improvement and there was no complication related with operation. CONCLUSION: This new technique is considered useful for direct repair of the defects in symptomatic lumbar spondylolysis without significant injury in the normal structures.
Head ; Humans ; Nuts ; Spine ; Spondylolysis*

Lumbar interbody fusion provides the most logical solution to diseases of the lumbar spine instabilities, such as spondylolysis, spondylolisthesis and retrolisthesis. The 33 cases of lumbar interbody fusion done after Cloward method, Wiltberger method, method using bovine bone employing Cloward technique, and anterolateral approach were analyzed. Posterior interbody fusion after Wiltberger technique using dowel bone graft is a more simplified method, providing accurate approximation of graft and host bone and preventing extrusion of graft then Cloward technique. Immediate correction of extruded graft if any after postoperative CT checking is essential for successful fusion.
Logic ; Spine ; Spondylolisthesis ; Spondylolysis ; Transplants

Abnormalities of the posterior arch, including congenitally absent cervical pedicle and cervical spondylolysis, are rare entities that are usually found incidentally on neck radiographs. It is important to recognize these characteristic radiological features because their radiographic appearance may cause them to be confused with more serious entities such as fractures, locked facets, and tumor-induced bony erosions. Also, it is important to distinguish these abnormalities from similar pathologies to prevent the use of inappropriate treatment. We report the relevant clinical and radiological findings seen in three cases of posterior arch defect after trauma with review of pertinent literature.
Congenital Abnormalities ; Neck ; Spine ; Spondylolysis

Lumbar spondylolysis and spondylolisthesis are common spinal disorders that most of the times are incidental findings or respond favorably to conservative treatment. In a small percentage of the patients, surgical intervention becomes necessary. Because too much attention has been paid to novel surgical techniques and new modern spinal implants, some of fundamental concepts have been forgotten. Identifying that small but important number of patients with lumbar spondylolysis or spondylolisthesis who would really benefit from lumbar surgery is one of those forgotten concepts. In this paper, we have developed an algorithmic approach to determine who is a good candidate for surgery due to lumbar spondylolysis or spondylolisthesis.
Humans ; Incidental Findings ; Lumbosacral Region ; Spondylolisthesis* ; Spondylolysis*

Unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis is rare even in the elderly. Most are associated with major trauma, previous spine surgery, or stress-related activity. Here, the authors describe an unique case of unilateral pedicle fracture associated with spondylolytic spondylolisthesis at the L5 level, which was successfully treated by posterior lumbar interbody fusion with screw fixation at the L5-S1 level. As far as the authors' knowledge, no such case has been previously reported in the literature. The pathophysiological mechanism of this uncommon entity is discussed and a review of relevant literature is included.
Aged ; Fractures, Stress ; Humans ; Spine ; Spondylolisthesis* ; Spondylolysis

Bilateral pedicle stress fracture is a rare entity and few cases have been reported in the literature. Furthermore, the majority of these reports concern previous spine surgery or stress-related activities. Here, the authors report ankylosing spondylitis as a new cause of bilateral pedicle stress fractures accompanying spondylolysis. The reported case adds to the literature on bilateral pedicle stress fracture and spondylolysis by documenting that ankylosing spondylitis is another cause of this condition.
Fractures, Stress ; Humans ; Spine ; Spondylitis, Ankylosing ; Spondylolysis