Characteristics and diagnostic factors associated with fresh lumbar spondylolysis in elementary school-aged children

Abstract

Purpose

We often encounter elementary school-aged children with fresh lumbar spondylolysis and non-union of bone. They may have factors that impede healing, and treatment outcomes need improvement. The purpose of this study was to investigate elementary school-aged patients with fresh lumbar spondylolysis and to identify characteristics that can aid in prompt diagnosis and proper therapy.

Methods

We retrospectively compared the characteristics of fresh lumbar spondylolysis in elementary school-aged children with those of older patients. We included patients aged 6–18 years with lower back pain and evidence of bone marrow oedema of lumbar pedicles on magnetic resonance imaging (MRI). The elementary school-aged group (group E) included 100 patients aged 6–12 years, and the senior group (group S) included 251 patients aged 13–18 years. We recorded patient sex, duration of lower back pain, injured site (lumbar level, unilateral/bilateral), presence of contralateral pars defect with evidence of high signal change on MRI (short tau inversion recovery), presence of spina bifida occulta (SBO), and follow-up treatment interruption rate.

Results

One-third of the patients in group E were female, and there was an even smaller proportion of females in group S. L5 lumbar spondylolysis was more common in group E. The treatment interruption rate was lower in group E. L5 SBO and contralateral pars defect were more common in group E.

Conclusion

L5 lumbar spondylolysis, L5 SBO, and contralateral pars defect were important diagnostic factors in elementary school-aged patients. Identification of these characteristics will aid in prompt diagnosis and proper therapy.

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Fig. 1

Data Availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

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Funding

None of the authors received financial support for this study.

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Contributions

Yuta Tsukagoshi made substantial contributions to the conception or design of the work and the acquisition, analysis, or interpretation of data in the work. Makoto Kamegaya and Masaki Tatsumura drafted the work or revised it critically for important intellectual content. All authors approved the version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Yuta Tsukagoshi.

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The authors declare no conflicts of interest.

Ethics approval

The Research Ethics Committee of our institution has confirmed that no ethical approval was required for this retrospective observational study.

Informed consent

We obtained no written patient consent for this retrospective survey. The retrospective review of medical records and radiographs received the approval of our institutional review board.

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Tsukagoshi, Y., Kamegaya, M., Tatsumura, M. et al. Characteristics and diagnostic factors associated with fresh lumbar spondylolysis in elementary school-aged children. Eur Spine J 29, 2465–2469 (2020). https://doi.org/10.1007/s00586-020-06553-x

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Keywords

  • Lumbar spondylolysis
  • Elementary school
  • Spina bifida occulta
  • Pseudarthrosis
  • Pars defect