Plain films of the lumbar spine were unremarkable (Not provided).
A diagnosis of spondylolysis at L5-S1 was made.
Spondylolysis is due to stress fractures of the posterior vertebral elements at the pars interarticularis from repetitive microtrauma. The pars interarticularis is the weakest part of the vertebra. Spondylolysis is associated with hyperextension sports such as gymnastics, diving, weight lifting, football, soccer and hockey. It is bilateral in up to 75% of cases, and is most common at L5-S1. It is present in 5% of the population, but is usually asymptomatic. Plain films early on can show sclerosis of the pars interarticularis, and later on can show the fracture lucency in the pars interarticularis known as the "Scotty dog" deformity. This is best seen on the oblique plain film. The contralateral pedicle is often sclerotic due to stress from increased load bearing. A bone scan, which is done with tomographic imaging to increase sensitivity, shows increased uptake at the fracture. CT, which is rarely necessary, shows an incomplete ring sign. If spondylolysis is bilateral, the patient can go on to develop vertebral subluxation at that level, resulting in spondylolisthesis. Spondylolisthesis is graded by the Meyerding Classification, where Grade I is 0-25% slippage, Grade II is 25-50% slippage, Grade III is 50-75% slippage, and Grade IV is 75-100% slippage.
Follow us on Twitter @pedseducation and @pedsimaging and Facebook @pedsimaging and Instagram @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.