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Newly occurred L4 spondylolysis in the lumbar spine with pre-existence L5 spondylolysis among sports players: case reports and biomechanical analysis

Archives of Orthopaedic and Trauma Surgery volume 129, pages 1433–1439 (2009)Cite this article

Abstract

Study design

Case series and a biomechanical study using a finite element (FE) analysis.

Objectives

To report three cases with multi-level spondylolysis and to understand the mechanism biomechanically.

Background

Multi-level spondylolysis is a very rare condition. There have been few reports in the literature on multi-level spondylolysis among sports players.

Methods

We reviewed three cases of the condition, clinically. These patients were very active young sports players and had newly developed fresh L4 spondylolysis and pre-existing L5 terminal stage spondylolysis. Thus, we assumed that L5 spondylolysis may have increased the pars stress at the cranial adjacent levels, leading to newly developed spondylolysis at these levels. Biomechanically, we investigated pars stress at L4 with or without spondylolysis at L5 using the finite element technique.

Results

L4 pars stress decreased in the presence of L5 spondylolysis, which does not support our first hypothesis.

Conclusions

It seems that multi-level spondylolysis may occur due to genetic and not biomechanical reasons.

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Affiliations

  1. Department of Orthopedics, The University of Tokushima School of Medicine, 3-18-15, Kuramoto, Tokushima, 770-8503, Japan

    Koichi Sairyo, Toshinori Sakai & Natsuo Yasui

  2. Departments of Bioengineering and Orthopedic Surgery, Engineering Center for Orthopaedic Research Excellence (ECORE), University of Toledo, Toledo, OH, USA

    Ali Kiapour, Ashok Biyani, Nabil Ebraheim & Vijay K. Goel

Authors
  1. Koichi Sairyo
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  2. Toshinori Sakai
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  3. Natsuo Yasui
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  4. Ali Kiapour
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  5. Ashok Biyani
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  6. Nabil Ebraheim
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  7. Vijay K. Goel
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Corresponding author

Correspondence to Koichi Sairyo.

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Sairyo, K., Sakai, T., Yasui, N. et al. Newly occurred L4 spondylolysis in the lumbar spine with pre-existence L5 spondylolysis among sports players: case reports and biomechanical analysis. Arch Orthop Trauma Surg 129, 1433–1439 (2009). https://doi.org/10.1007/s00402-008-0795-3

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  • DOI: https://doi.org/10.1007/s00402-008-0795-3

Keywords

  • Multi-level spondylolysis
  • Sports players
  • Biomechanics
  • Mechanical stress