Postoperative radiographic evidence for fatigue fracture as the etiology in spondylolysis

The postoperative radiographs of 48 patients who underwent posterolateral in situ fusion for spondylolysis and Grade 1 or less spondylolisthesis over an 11-year period showed healing of the pars defects in 90% of the cases. The patients who showed healing had an average preoperative duration of symp...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 1989-12, Vol.14 (12), p.1342-1355
Main Authors: O'NEILL, D. B, MICHELI, L. J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Athletic Injuries - complications
Biological and medical sciences
Child
Diseases of the osteoarticular system
Diseases of the spine
Female
Fractures, Stress - complications
Fractures, Stress - diagnostic imaging
Humans
Lumbosacral Region
Male
Medical sciences
Nervous System Diseases - etiology
Orthopedic Fixation Devices
Postoperative Period
Radiography
Retrospective Studies
Sex Factors
Spinal Fusion
Spondylolisthesis - etiology
Spondylolysis - etiology
Spondylolysis - physiopathology
Spondylolysis - surgery
Time Factors
Wound Healing
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Summary:The postoperative radiographs of 48 patients who underwent posterolateral in situ fusion for spondylolysis and Grade 1 or less spondylolisthesis over an 11-year period showed healing of the pars defects in 90% of the cases. The patients who showed healing had an average preoperative duration of symptoms of 17 months (mean, 12 months). The five patients whose radiographs showed persistent defects postoperatively were found to have had preoperative symptoms for an average of 47 months (mean, 48 months). This significantly greater (P 0.05) duration of symptoms prior to stabilization was the only variable that proved to be statistically significant. Controversy continues to exist as to the etiology of spondylolysis; however, the ability to heal the defect with lumbar spinal stability certainly supports the theory that the defect is a result of fatigue stresses, which finally manifest as a fracture seen on radiographs as the spondylolytic defect. Posterior spinal stabilization in those patients with symptoms for a period of less than 2 years who have failed conservative management can be expected to heal the pars defects.
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-198912000-00011