SPONDYLOL YSIS AND SPONDYLOLISTHESIS Spondylolysis

SPONDYLOL YSIS AND SPONDYLOLISTHESIS Spondylolysis

This is a unilateral or bilateral defect in the pars interarticu - laris without vertebral slippage. The incidence is reported in approximately 6% by the age of 14 years, but is much higher in the young athletic population. The diagnosis is di ffi cult to confir m with plain radiographs. Reverse gantry CT , MRI and single photon emission computed tomography (SPECT) are useful investigations for this condition. Treatment involves rest, non-steroidal anti-inflammatory medication, activity modifi - cation and a lumbosacral orthosis. For patients who remain symptomatic despite an adequate trial of non-operative care, surgery in the form of a direct repair of the pseudarthrosis b y a Buck’s fusion may be indicated. Spondylolysis /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Incidence in general population 6% by 14 years Incidence in athletic population 15–47% May be completely asymptomatic/incidental /f_i nding on radiograph Dif /f_i cult to image, but MRI proving more useful Conservative treatment: activity modi /f_i cation, anti-lordotic brace Surgical treatment: direct repair preserving motion or spinal fusion if associated disc degeneration

SPONDYLOL YSIS AND SPONDYLOLISTHESIS Spondylolysis

This is a unilateral or bilateral defect in the pars interarticu - laris without vertebral slippage. The incidence is reported in approximately 6% by the age of 14 years, but is much higher in the young athletic population. The diagnosis is di ffi cult to confir m with plain radiographs. Reverse gantry CT , MRI and single photon emission computed tomography (SPECT) are useful investigations for this condition. Treatment involves rest, non-steroidal anti-inflammatory medication, activity modifi - cation and a lumbosacral orthosis. For patients who remain symptomatic despite an adequate trial of non-operative care, surgery in the form of a direct repair of the pseudarthrosis b y a Buck’s fusion may be indicated. Spondylolysis /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Incidence in general population 6% by 14 years Incidence in athletic population 15–47% May be completely asymptomatic/incidental /f_i nding on radiograph Dif /f_i cult to image, but MRI proving more useful Conservative treatment: activity modi /f_i cation, anti-lordotic brace Surgical treatment: direct repair preserving motion or spinal fusion if associated disc degeneration

SPONDYLOL YSIS AND SPONDYLOLISTHESIS Spondylolysis

This is a unilateral or bilateral defect in the pars interarticu - laris without vertebral slippage. The incidence is reported in approximately 6% by the age of 14 years, but is much higher in the young athletic population. The diagnosis is di ffi cult to confir m with plain radiographs. Reverse gantry CT , MRI and single photon emission computed tomography (SPECT) are useful investigations for this condition. Treatment involves rest, non-steroidal anti-inflammatory medication, activity modifi - cation and a lumbosacral orthosis. For patients who remain symptomatic despite an adequate trial of non-operative care, surgery in the form of a direct repair of the pseudarthrosis b y a Buck’s fusion may be indicated. Spondylolysis /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Incidence in general population 6% by 14 years Incidence in athletic population 15–47% May be completely asymptomatic/incidental /f_i nding on radiograph Dif /f_i cult to image, but MRI proving more useful Conservative treatment: activity modi /f_i cation, anti-lordotic brace Surgical treatment: direct repair preserving motion or spinal fusion if associated disc degeneration