T1-VIBE and STIR MRI of lumbar pars interarticularis injuries in elite athletes: fracture characterisation and potential prognostic indicators

Objectives To assess how pars interarticularis fracture characteristics on T1-VIBE and STIR MRI relate to healing and identify anatomical parameters that may impact healing. Materials and methods A retrospective review of an MRI series of lumbar pars interarticularis injuries in elite athletes over...

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Bibliographic Details
Published in:Skeletal radiology 2024-03, Vol.53 (3), p.489-497
Main Authors: Watura, Christopher, Mitchell, Adam W. M., Fahy, Damian, Houghton, Jonathan, Kang, Sujin, Lee, Justin C.
Format: Article
Language:English
Subjects:
Athletes
Bone healing
Bone marrow
Edema
Fractures
Healing
Imaging
Injuries
Magnetic resonance imaging
Medicine
Medicine & Public Health
Nuclear Medicine
Orthopedics
Osteoclasts
Parameter identification
Pathology
Radiology
Scientific Article
Statistical analysis
Vertical orientation
Wound healing
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Summary:Objectives To assess how pars interarticularis fracture characteristics on T1-VIBE and STIR MRI relate to healing and identify anatomical parameters that may impact healing. Materials and methods A retrospective review of an MRI series of lumbar pars interarticularis injuries in elite athletes over a 3-year period. Fracture configurations, signal intensities and anatomical parameters were recorded by two radiologists. Statistical analysis employed multilevel mixed-effects linear regressions, adjusted for repeated measures and baseline covariates. Results Forty-seven lumbar pars interarticularis injuries among 31 athletes were assessed. On final scans for each athlete, 15% (7/47) injuries had worsened, 23% (11/47) remained stable, 43% (20/47) partially healed and 19% (9/47) healed completely. Healing times varied, quickest was 49 days for a chronic fracture in a footballer. Bone marrow oedema signal was highest in worsened fractures, followed by improved, and lowest in stable fractures. As healing progressed, T1-VIBE signal at the fracture line decreased. Bone marrow oedema and fracture line signal peaked at 90–120 days before decreasing until 210–240 days. Fractures with smaller dimensions, more vertical orientation and a longer superior articular facet beneath were significantly associated with better healing ( p  
ISSN:0364-2348
1432-2161
DOI:10.1007/s00256-023-04437-x