Abstract
Study Design: The lumbar spine of children an adolescents with suspected spondylolysis was assessed by magneting resonance imaging.
Objectives: To evaluate the value of MRI in diagnosis and after nonoperative treatment of incipient spondylolysis in children and adolescents.
Summary of Background Data: The diagnosis of incipient spondylolysis in children and adolescents is difficult. Radiographs have a low sensitivity and the use of bone scans, computer tomography and MRI controversial.
Methods: The study is prospective. The lumbar spine was assessed by MR imaging in children (n=14, mean age 12.4 years) with unspecific low back pain for more than 3 weeks and normal plain radiographs at presentation. Six of the seven children were involved in moderate to severe sport activities.
Incipient spondylolysis was diagnosed when on T1 sequences a hypointense area was found within the pars interarticularis of any lumbar vertebra while on T2 sequences a corresponding hyperintense zone was detected. Brace and activity restriction was recommended. Follow-up MRI studies were performed after treatment at 3 months interval.
Results: Seven of 14 patients presented with pars edema (T1 hypointense, T2 hyperintense), six at L5 vertebra, one at L4 and L5 vertebra, respectively. After 3 months healing was demonstrated both clinically and by imaging in six children in another child healing was observed after 6 months.
Conclusions: MRI showed promising results in detecting and monitoring the early onset of spondylolysis. In our cases early treatment prevented pars defects.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
