• Asian Spine Journal
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• 제12권6호
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• pp.1037-1042
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• 2018

Study Design: Retrospective study. Purpose: This study aimed to investigate whether segmental lumbar hyperlordosis of the affected vertebra in patients with spondylolysis occurs only at L5 or also occurs at L4. Overview of Literature: To the best of our knowledge, increase in segmental lordosis of the spondylolytic vertebrae has only been investigated in bilateral L5 spondylolysis; it has not been examined at different levels of bilateral spondylolysis. According to the characteristics of segmental lordosis in bilateral L5 spondylolysis, patients with bilateral L4 spondylolysis may also have increased segmental lordosis of the L4 vertebra. Methods: Patients with bilateral spondylolysis of the L5 or L4 vertebra in 2013-2015 were retrospectively identified from the hospital database. Standing lateral lumbar radiographs were assessed for the angle of segmental lordosis of the L5 and L4 vertebra, sacral slope, and lumbar lordosis. The differences in segmental lordosis of the L5 and L4 vertebra, sacral slope, and lumbar lordosis were determined using non-paired Student t-test. Results: Overall, 15 cases of bilateral L4 spondylolysis and 41 cases of bilateral L5 spondylolysis satisfied the inclusion and exclusion criteria. Lordosis of the L4 vertebra was significantly greater in the bilateral L4 spondylolysis group ($24.2^{\circ}{\pm}7.0^{\circ}$) than that in the L5 spondylolysis group ($20.3^{\circ}{\pm}6.1^{\circ}$, p=0.047). Lordosis of the L5 vertebra was significantly lower in the L4 spondylolysis group ($27.7^{\circ}{\pm}8.2^{\circ}$) than that in the L5 spondylolysis group ($32.5^{\circ}{\pm}7.3^{\circ}$, p=0.040). The sacral slope and lumbar lordosis did not significantly differ between the groups. Conclusions: Adolescent patients with bilateral spondylolysis have segmental hyperlordosis of the affected vertebra not only at the L5 level but also at the L4 level.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.207-210
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• 2013

Objective : To compare spinopelvic parameters in young adult patients with spondylolysis to those in age-matched patients without spondylolysis and investigate the clinical impact of sagittal spinopelvic parameters in patients with L5 spondylolysis. Methods : From 2009 to 2012, a total of 198 young adult male patients with spondylolysis were identified. Eighty age-matched patients without spondylolysis were also selected. Standing lateral films that included both hip joints were obtained for each subject. Pelvic incidence (PI), sacral slope (SS), pelvic tilt, lumbar lordosis angle, sacral inclination, lumbosacral angle, and sacral table angle were measured in both groups. A comparative study of the spinopelvic parameters of these two groups was performed using SPSS 15.0 (SPSS Inc., Chicago, IL, USA). Results : Among the aforementioned spinopelvic parameters, PI, SS and STA were significantly different between patients with spondylolysis and those without spondylolysis. PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Conclusion : PI and SS were higher in the spondylolysis group than in the control group, but STA was lower in the spondylolysis group than in the control group. Patients with spondylolysis have low STA at birth, which remains constant during growth; a low STA translates into high SS. As a result, PI is also increased in accordance with SS. Therefore, we suggest that STA is an important etiologic factor in young adult patients with L5 spondylolysis.

• Journal of Korean Neurosurgical Society
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• 제48권1호
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• pp.70-72
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• 2010

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.

• 대한영상의학회지
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• 제81권3호
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• pp.644-653
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• 2020

목적 이 연구는 요추 후방감압술에서 발생한 후천적 척추분리증과 척추전방전위증의 다중검출 전산화단층촬영 소견에 대해 분석하고자 하였다. 대상과 방법 2003년부터 2017년까지 요추 후방감압술을 시행 받고 수술 전 및 수술 후 다중검출 전산화단층촬영을 촬영한 74명의 환자를 대상으로 하였다. 유합술을 시행하지 않은 1군과 유합술을 시행한 2군의 환자로 분류하였다. 수술 후 다중검출 전산화단층촬영 영상에서 요추 후방감압술의 크기, 척추분리증 또는 척추전방전위증 유무와 위치, 척추전방전위증의 유무, 후방관절 및 척추주위 근육의 지방 변화에 대해 분석하였다. 결과 후천적 척추분리증 또는 척추전방전위증의 빈도는 1군에서 20명 중 4명, 2군에서 54명 중 2명이였다. 후방감압술의 크기(%)는 전체 추궁판에 대한 추궁절제술의 크기를 백분율로 계산하였다. 요추 후방감압술의 크기(%)는 후천적 척추분리증 또는 척추전방전위증이 있는 경우 54.0 (1군)과 53.2 (2군)이었고, 후천적 척추분리증과 척추전방전위증이 없는 경우는 35.0(1군)이었다. 척추분리증의 위치는 1군에서는 후방감압술 분절의 후관절 부근에서 발생하며, 2군에서는 유합술 하방의 관절 간부에 발생하였다. 결론 다중검출 전산화단층촬영은 요추 후방감압술 이후 후천적 척추분리증과 척추전방전위증을 진단하는 데 유용하고, 후천적 척추분리증의 전형적인 위치를 잘 보여준다. 요추 후방감압술의 크기가 클수록 후천적 척추분리증과 척추전방전위증의 발생과 연관이 있었다.

• 한방재활의학과학회지
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• 제30권1호
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• pp.95-103
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• 2020

Objectives The purpose of this study is to assess the effect of korean medicinal admission treatment for degenerative lumbar diseases with spondylolysis and analyze their radiological findings. Methods This study was performed on 25 cases' medical records of spondylolysis patients with both X-rays and MRI images. Their general characteristics, morphologies of intervertebral discs, grades of spondylolisthesis, grades of intervertebral foraminal stenosis were analyzed. The efficacy of treatment was evaluated by numeric pain rating scale (NPRS) changes and statistically assessed by paired t-test using program R Studio. Results After admission treatment, NPRS scores significantly decreased from 6.76±2.07 to 2.38±1.22 (p<0.01). Spondylolysis was associated with degenerative disc change and intervertebral foraminal stenosis at the same or adjacent vertebral level. In spondylolisthesis cases (76%), forward slippage occurred at the same level of spondylolysis in every case. Conclusions Spondylolysis could play a key role in the lumbar degenerative mechanism and korean medicinal admission treatment is effective on pain relief of degenerative lumbar diseases with spondylolysis.

• The Korean Journal of Pain
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• 제18권2호
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• pp.251-254
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• 2005

Spondylolysis, also known as stress injury of pars interarticularis, is a common cause of back pain in athletes, particularly children and young adults. Repeated minor traumas during flexion and extension of the spine are thought to result in bony failure due to excessive bone resorption. These lesions are common in the low back, with the majority found at the L5 vertebra. In the majority of cases of spondylolysis, non-operative treatments are recommended, such as NSAIDs, physiotherapy and bracing. Only if symptoms do not respond to conservative treatments should surgical intervention be considered. Recently, pars interarticularis injections for diagnostic and therapeutic purposes have been found to allow significant pain relief from spondylolysis for long periods. Here, the case of a 57-year-old man with spondylolysis, who suffered from back pain, which was not relieved by an epidural steroid injection, but in whom pars interarticularis injections of local anesthetic and steroid induced complete transient pain relief, following by moderate long-term relief, is presented.

• 대한영상의학회지
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• 제83권1호
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• pp.127-137
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• 2022

목적 소아에서 우연히 발견되는 요추 척추분리증의 유병률을 평가하고자 한다. 대상과 방법 2014년 3월부터 2018년 12월까지 복부-골반 컴퓨터단층촬영술을 시행한 11세 미만의 환자 809명(평균나이 7.0 ± 2.7세, 남아:여아 = 479:330)의 자료를 후향적으로 분석하였다. 척추분리증의 유무, 척추분리증이 있는 위치, 그리고 편측성(일측성 혹은 양측성)을 기록하였다. 척추분리증의 유무에 따라 환자군 spondylolysis (이하 SP) 그룹과 non-SP 그룹으로 나누었다. 결과 20명의 환자에서 21개의 척추분리증이 확인되었다(20/809, 2.5%). SP 그룹의 평균 나이가 non-SP 그룹보다 많았다(7.8 ± 1.8세 vs. 6.9 ± 2.7세, p > 0.05). 남아에서 여아보다 유병률이 높았다(15/479 [3.1%] vs. 5/330 [1.5%], p > 0.05). 만 6-10세의 학령기 연령에서 만 0-5세의 미취학 연령보다 유병률이 높았다(17/538 [3.2%] vs. 3/271 [1.1%], p > 0.05). 척추분리증은 요추 5번에서 가장 흔하게 보였고(76.2%), 8세 남아에서 두 개의 요추에서 척추분리증을 보였다. 10세 남아에게서 척추분리전방전위증이 확인되었다(1/809, 0.1%). 11건의 일측성 척추분리증은 확인되었다(11/21, 52.4%). 결론 본 연구에서 11세 미만의 환자에서 척추분리증의 유병률은 2.5%였다. 척추분리증은 여아보다는 남아에게서, 미취학 연령군보다는 학령기 연령군에서 더 높은 유병률을 보였으나, 통계학적으로 유의미한 차이는 없었다.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.584-587
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• 2009

Although most authors regard contralateral pedicular fracture with unilateral spondylolysis as an unstable condition and recommend surgical management when immobilization fails in promoting bony healing of the fracture, few researchers have investigated the natural history of pedicle fracture or the causal relationship between symptoms and the fracture. In addition, there are no detailed guidelines that address the management of this disease. We report a rare case of contralateral pedicular fracture associated with unilateral spondylolysis at the L5 level which was successfully treated by rehabilitation with activity modification.

• The Journal of Korean Physical Therapy
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• 제15권4호
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• pp.24-33
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• 2003

Spondylolysis and spondylolisthesis are two conditions that directly involve changes in the vertebra. Spondylolysis is defined as a defect in the pars interarticularis, the region of the lamina between the superior and inferior articular facets. Progression of the defect can result in spondylolisthesis, which is defined as a subluxation or 'slippage' of two adjacent vertebrae. In the low back it occurs most commonly at the lumbosacral level; next in frequency is spondylolisthesis of the fourth lumbar vertebra on the fifth. To provide the reader with information about the aetiology and anatomical consideration of spondylolysis and spondylolisthesis type. Spondylolisthesis has recently been classified by Wiltse and others into five types based on the suspected aetiology; dysplastic, isthmic, degenerative, posttraumatic, pathologic and postsurgical. Of these five types, isthmic spondylolisthesi and degenerative spondylolisthesis, both of which are frequently associated with low back and lower limb pain.

• 대한물리의학회지
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• 제2권1호
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• pp.93-99
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• 2007

Purpose : The aim of this study is to consider degenerative spine disease theoretically and compare plain radiography which is a basic study for low back pain with MRI in cases of degenerative lumbar spine disease to find out whether the abnormalities agree with each other. Methods : In 4 cases of lumbar degenerative disease, we studied the relation of the abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis and osteophytes on plain radiography with those on MRI of HIVD, spinal stenosis and spondylolisthesis. Results : Many abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis, osteophytes and change of cortex & bone marrow on plain radiography suggest HIVD, spinal stenosis, spondylolysis or spondylolisthesis on MRI. Conclusion : For low back pain patients, plain radiography is a basic study in diagnosis of HIVD, spinal stenosis, spondylolysis or spondylolisthesis but MRI or CT scan is necessary to develop(build) a treatment plan like an operation.