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Synchronic multiple stress fractures of L5 left hemilamina: a case of an unusual type of lumbar spondylolysis

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Abstract

Lumbar spondylolysis is a stress fracture that commonly occurs in adolescent sports players. It is found in approximately 6% of the adult general population. The condition is usually detected as a defect in the pars interarticularis, sometimes in the pedicle (pediculolysis), and rarely in the lamina (laminolysis). Such fractures are typically seen as one defect in each side of the lamina: multiple stress fractures in the same side of the lamina rarely occur synchronically. Here, we report an unusual type of lumbar spondylolysis in the form of synchronic multiple stress fractures of the L5 left hemilamina in an adolescent baseball player. Conservative treatment was effective for bony healing. Although this type of spondylolysis is very rare, to avoid overlooking it, it is essential to examine reconstructed CT images and take the patient’s history carefully. If an accurate diagnosis is made early, conservative treatment may be sufficient to achieve bony healing.

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References

  1. Sairyo K, Katoh S, Sakamaki T, Komatsubara S, Endo K, Yasui N (2003) Three successive stress fractures at the same level in an adolescent baseball player. Am J Sports Med 31:606–610

    PubMed  Google Scholar 

  2. Terai T, Sairyo K, Goel VK, Ebraheim N, Biyani A, Faizan A et al (2010) Spondylolysis originates in the ventral aspect of the pars interarticularis: a clinical and biomechanical study. J Bone Joint Surg Br 92:1123–1127

    Article  PubMed  CAS  Google Scholar 

  3. Wiltse LL (1962) The etiology of spondylolisthesis. J Bone Joint Surg Am 44:539–560

    PubMed  Google Scholar 

  4. Wiltse LL, Widell EH Jr, Jackson DW (1975) Fatigue fracture: the basic lesion in isthmic spondylolisthesis. J Bone Joint Surg Am 57:17–22

    PubMed  CAS  Google Scholar 

  5. Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP (1984) The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am 66:699–707

    PubMed  CAS  Google Scholar 

  6. Sakai T, Sairyo K, Takao S, Nishitani H, Yasui N (2009) Incidence of lumbar spondylolysis in the general population in Japan based on multidetector computed tomography scans from two thousand subjects. Spine 34:2346–2350

    Article  PubMed  Google Scholar 

  7. Sairyo K, Katoh S, Sasa T, Yasui N, Goel VK, Vadapalli S et al (2005) Athletes with unilateral spondylolysis are at risk of stress fracture at the contralateral pedicle and pars interarticularis: a clinical and biomechanical study. Am J Sports Med 33:583–590

    Article  PubMed  Google Scholar 

  8. Sakai T, Sairyo K, Takao S, Kosaka H, Yasui N (2010) Adolescents with symptomatic laminolysis: report of two cases. J Orthop Traumatol 11:189–193

    Article  PubMed  Google Scholar 

  9. El Rassi G, Takemitsu M, Woratanarat P, Shah SA (2005) Lumbar spondylolysis in pediatric and adolescent soccer players. Am J Sports Med 33:1688–1693

    Article  PubMed  Google Scholar 

  10. Hu SS, Tribus CB, Diab M, Ghanayem AJ (2008) Spondylolisthesis and spondylolysis. J Bone Joint Surg Am 90:656–671

    PubMed  Google Scholar 

  11. Sakai T, Yamada H, Nakamura T, Nanamori K, Kawasaki Y, Hanaoka N et al (2006) Lumbar spinal disorders in patients with athetoid cerebral palsy: a clinical and biomechanical study. Spine 31:E66–E70

    Article  PubMed  Google Scholar 

  12. Sakai T, Yamada H, Nakamura T, Nanamori K, Kawasaki Y, Hanaoka N et al (2006) Lumbar spinal disorders in patients with athetoid cerebral palsy: a clinical and biomechanical study. Spine 31:E66–E70

    Article  PubMed  Google Scholar 

  13. Belfi LM, Ortiz AO, Katz DS (2006) Computed tomography evaluation of spondylolysis and spondylolisthesis in asymptomatic patients. Spine 31:E907–E910

    Article  PubMed  Google Scholar 

  14. Roche MB, Rowe GG (1951) The incidence of separate neural arch and coincident bone variations. A survey of 4,200 skeletons. Anat Rec 109:233–252

    Article  PubMed  CAS  Google Scholar 

  15. Sairyo K, Katoh S, Takata Y, Terai T, Yasui N, Goel VK et al (2006) MRI signal changes of the pedicle as an indicator for early diagnosis of spondylolysis in children and adolescents: a clinical and biomechanical study. Spine 31:206–211

    Article  PubMed  Google Scholar 

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No funds were received in support of this study.

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Correspondence to Koichi Sairyo.

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Sakai, T., Sairyo, K., Mase, Y. et al. Synchronic multiple stress fractures of L5 left hemilamina: a case of an unusual type of lumbar spondylolysis. Eur J Orthop Surg Traumatol 22 (Suppl 1), 41–43 (2012). https://doi.org/10.1007/s00590-012-0953-8

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  • DOI: https://doi.org/10.1007/s00590-012-0953-8

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