Painful lumbar spondylolysis among pediatric sports players: A pilot MRI study
Archives of Orthopaedic and Trauma Surgery, 06/24/2011  Clinical Article

Sairyo K et al. – The present study showed that inflammation was always present at the pars defects and in some cases at the adjoining facet joints. Thus, it is not difficult to understand how, during sports activity, inflammation may first occur at the pseudoarthrotic site and then spread to the adjoining facet joints. This mechanism could cause LBP associated with terminal-stage (pseudoarthrotics) spondylolysis in athletes.

• 6 pediatric athletes (5 boys and 1 girl) below 18 years old with painful bilateral lumbar spondylolysis were evaluated
• In all cases, spondylolysis was identified as terminal stage (pseudoarthrosis) on CT scan
• To evaluate inflammation around the pars defects, short time inversion recovery (STIR) MRI was performed along with sagittal section
• Fluid collection, which is an indicator of inflammatory events, was evaluated in 12 pars defects as well as in 12 cranial and caudal adjoining facet joints

• Inflammation (i.e., fluid collection) was observed in all 12 pars defects in 6 subjects at the pseudoarthrotic pars defects
• In terms of facet joints, 7 of 12 (58%) pars defects showed fluid collection at the cranial and/or caudal adjoining joints on STIR MRI