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Xinyu Liu, Lianlei Wang, Suomao Yuan, Yonghao Tian, Yanping Zheng and Jianmin Li

Among the general population, the estimated incidence of lumbar spondylolysis is 3%–10% and that of isthmic spondylolisthesis is 2.6%–4.4%. 4 Lumbar spondylolysis and isthmic spondylolisthesis occur most commonly at a single spinal level, usually the unilateral or bilateral L-5 pars interarticularis. Only a few cases of multiple-level lumbar spondylolysis have been reported. 1–3 , 5–11 Ravichandran 8 calculated that only 1.48% of patients with back pain have multiple-level spondylolysis. Sakai et al. 9 reviewed CT scans of 2000 persons without low

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Emrah Celtikci, Fatih Yakar, Pinar Celtikci and Yusuf Izci

yet have such a surveillance system. Spondylolysis is a weakness or stress fracture in one of the bone bridges that connect the upper with the lower facet joints of the spinal column. The frequency of spondylolysis is as high as 6% of the population. 26 Spondylolysis is a common cause of low-back pain (LBP) and most commonly affects gymnasts, football linemen, weightlifters, wrestlers, dancers, and drivers. This condition is aggravated by physical activity. CT, in particular high-definition multiplanar imaging devices, and MRI are the diagnostic tools of

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Koichi Sairyo, Shinsuke Katoh, Tadanori Sakamaki, Shinji Komatsubara and Natsuo Yasui

G ill , et al., 5 were the first to describe nonfusion decompressive surgery in patients with lumbar spondylolysis. Subsequently, some authors reported that the operation reported by Gill, et al., would result in further vertebral slippage postoperatively; therefore, some surgeons recommended decompression with spinal fusion. 7, 9, 14 It was, however, also reported that long-term excellent or good results were observed in some patients after the Gill operation. 1, 2, 8, 10 They concluded that the Gill operation was of most benefit to the adult patient with

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Laura A. Snyder, Harry Shufflebarger, Michael F. O'Brien, Harjot Thind, Nicholas Theodore and Udaya K. Kakarla

S pondylolysis is a unilateral or bilateral defect in the pars interarticularis of the vertebra and is usually due to acute or repetitive microtrauma. The incidence of spondylolysis is estimated to be 6%–7% in the general adult population. 1 The entity is not observed in nonambulatory infants, and the incidence at age 6 years is approximately 5%. Hereditary predisposition and erect ambulation are thought to contribute to the development of the condition. This type of defect most commonly occurs at L-5, as this is the vertebra subjected to the greatest

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Xinqiang Yao, Ruoting Ding, Junhao Liu, Siyuan Zhu, Jingshen Zhuang, Zhongyuan Liu, Hui Jiang, Dongbin Qu, Qingan Zhu and Jianting Chen

L umbar spondylolysis refers to pars defects in the lumbar vertebrae. Patients with bilateral spondylolysis may progress to isthmic spondylolisthesis and tend to have more severe degenerative changes in facet joints and discs, which cause a variable clinical syndrome of back and/or lower-extremity pain. 10 , 14 Multiple factors may lead to the development of spondylolysis and spondylolisthesis, including hereditary predisposition, sport activities, sacropelvic orientation, and vertebral morphology. 20 , 24 Isthmus defects occur most frequently in L5. 8 An

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Koichi Sairyo, Toshinori Sakai, Natsuo Yasui and Akira Dezawa

I n pediatric patients with lumbar spondylolysis, the ideal goal is to achieve bone healing conservatively. Indeed, there have been some reports of successful bone healing in pediatric patients with spondylolysis in which various kinds of braces, such as the Boston brace (Boston Brace Co.) and a soft corset, have been used. 5 , 8 , 19 , 27 A biomechanics study reported that extension and axial rotation caused greater mechanical stress at the pars interarticularis, which may lead to stress fractures of the pars (spondylolysis). 13 Furthermore

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George R. Prioleau and Charles B. Wilson

-corticated bone margins of the pars interarticularis defects at C3–5 on the left side (arrows) . Discussion Table 1 outlines the cases of cervical spondylolysis with spondylolisthesis reported in the English medical literature. Four patients had bilateral spondylolysis, three had varying unilateral involvement, and two had only elongation of the pars interarticularis. The prevalent site of involvement appears to be C-6 with only two cases involving another level, C-4. Most cases occurred in males (seven of nine patients). Although trauma was a precipitating

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Nasser Mohammed, Devi Prasad Patra, Vinayak Narayan, Amey R. Savardekar, Rimal Hanif Dossani, Papireddy Bollam, Shyamal Bir and Anil Nanda

T he bipedal gait of Homo sapiens has an evolutionary advantage to our survival but has put a biomechanical disadvantage on the lumbar spine. Spondylolysis is defined as a defect of the pars interarticularis, either unilateral or bilateral; it is estimated to occur in 3%–7% of the adult population. 3 Sport activities carry a higher risk of spondylolysis with repetitive axial loading and hyperextension. The incidence of spondylolysis has been reported to be as high as 55% in fast bowlers. 14 The repeated stresses that fall on the pars in highly demanding

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Qing-shuang Zhou, MM, Xu Sun, Xi Chen, Liang Xu, Bang-ping Qian, Ze-zhang Zhu, Bin Wang and Yong Qiu

L umbar spondylolysis, sometimes combined with spondylolisthesis, predominantly occurs at the lumbosacral monosegment (mono_lysis). 1 , 2 It is rare but possible for spondylolysis to be detected at consecutive multiple regions of the lumbar spine (multi_lysis). 3 , 4 Spondylolysis, with or without spondylolisthesis, is usually asymptomatic; however, some patients may present with intractable back pain or radicular symptoms. 2 If conservative treatment fails, surgical intervention is an effective solution to achieve solid fusion, neurological decompression

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Oren N. Gottfried, Scott L. Parker, Ibrahim Omeis, Ali Bydon, Ziya L. Gokaslan and Jean-Paul Wolinsky

S pondylolysis , a bony defect of the vertebral arch, most commonly occurs in the lumbar spine and is present in 5% of the population. 1 It may or may not be associated with spondylolisthesis or instability. 1 Spondylolysis of cervical vertebrae, first described in 1951 by Perlman and Hawes, 22 is an extremely rare condition, and to date there have been 150 cases reported in the literature. 2 , 6 , 7 , 10 , 12–14 , 17 , 19 , 21 , 23 , 24 , 26 , 28 Cervical spondylolysis involves a cleft at the junction of the superior and inferior facet joints, the pars