The nature of the spondylolytic defect. Demonstration of a communicating synovial pseudarthrosis in the pars interarticularis.

نویسندگان

  • J A Shipley
  • C A Beukes
چکیده

We injected methylene blue dye into 32 of the facet joints immediately above the defects in 17 consecutive patients with bilateral spondylolysis (34 defects). In 30 of these the dye flowed into a central cavity in the defect of the pars interarticularis and in 20 it passed into the facet joint below the defect. We found macroscopic cavities in 32 of the defects which communicated with the adjacent facet joints and had fibrous capsules. Histological examination showed focal areas of synovial lining consistent with a synovial pseudarthrosis. In most patients requiring surgery for spondylolysis, the defect is a synovial pseudarthrosis which communicates with the facet joint above it, and less often with the facet joint below it. We suggest that stress fractures of the pars may fail to heal because of the presence of synovial fluid from a nearby facet joint.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Stress Fractures of Pars Interarticularis in Adolescent Athletes a Classification System with MRI and CT Enabling Evaluation of The Healing Process

Introduction: The purpose of this study was to evaluate healing frequency in different stages of stress reactions in the Pars Interarticularis (PI) using a classification system with MRI and CT. The intervention was 3-month rest from physical activity, without a brace, with the exception of activities of daily living. Materials & Method: Twelve adolescent athletes with different stages of Spond...

متن کامل

Osteoid Osteoma Can Occur at the Pars Interarticularis of the Lumbar Spine, Leading to Misdiagnosis of Lumbar Spondylolysis

BACKGROUND Osteoid osteomas are benign bone-forming tumors characterized by local inflammation and pain. They are also characterized by a small osteolytic lesion (nidus). Spondylolysis is a defect of the pars interarticularis, which may lead to stress fractures, and is a common cause of low back pain in adolescence. Osteoid osteoma occurs predominantly in the posterior elements of the spine. Ma...

متن کامل

Anatomic Variability of 120 L5 Spondylolytic Defects

Study Design Adult human osteologic specimens were assessed for spondylolytic defects and characterized. Objectives To characterize and determine the prevalence of spondylolytic defects in an osteological collection. Methods Lumbar vertebrae from the Hamann-Todd Osteological Collection at the Cleveland Museum of Natural History were examined. Digital images of specimens with L5 isthmic spondylo...

متن کامل

The oblique cranial tilt view for spondylolysis.

Spondylolysis is a common cause of backache and the detection of subtle cases is therefore important. Oblique views considerably increase the detection rate (Appleby and Stabler 1969), but a number of cases require additional views. The 30#{176} oblique cranial tilt view is more reliable than the standard oblique views in detecting spondylolysis as it visualises the pars interarticularis tangen...

متن کامل

The reduction and direct repair of isthmic spondylolisthesis using the smiley face rod method in adolescent athlete: Technical note.

Presently, lumbar spondylolisthesis did not have the indication of direct repair surgery because of the difficulty to reduce the slippage. In this report, we presented a case and described a minimally invasive direct repair surgery to reduce and repair the pars interarticularis defects of lumbar spondylolisthesis. First, curettage and removal of the synovium of the pars interarticularis and dec...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • The Journal of bone and joint surgery. British volume

دوره 80 4  شماره 

صفحات  -

تاریخ انتشار 1998