摘要

BACKGROUND:The main clinical symptom of lumbar spondylolysis is lower back pain. Radiculopathy rarely occurs without vertebral slippage. Hypothesis Spondylolysis in young athletes can cause lumbar radiculopathy.
STUDY DESIGN:Case series; Level of evidence, 4.
METHODS:Ten patients (7 males and 3 females) were included in this study. The age of the patients ranged from 12 to 27 years. We employed plain radiography, computed tomography, magnetic resonance imaging, and selective radiculography if needed.
RESULTS:The pathomechanism was classified into nonspondylolytic radiculopathy (3 cases) and spondylolytic radiculopathy (7 cases). In the nonspondylolytic group, 1 patient had a juxta-facet cyst at L4-5 and 2 patients had a herniated nucleus pulposus. In the other group, spondylolytic-related factors caused radiculopathy, and spondylolysis was in the early or progressive stage in all 7 patients. Radiologic findings indicated that radiculopathy was caused by extraosseous hematoma or edema in the vicinity of the fracture site. The radiculopathy disappeared within a month of nonoperative management, and radiologic abnormalities disappeared 3 to 6 months later.
CONCLUSION:Radiculopathy can occur together with lumbar spondylolysis without slippage in young athletes. We propose extra-osseous hematoma or edema at the site of spondylolysis as the unique pathomechanism causing radiculopathy in young athletes. Radiculopathy is rare in athletes with spondylolysis. Magnetic resonance imaging is a useful tool to clarify the pathologic changes that induce the radiculopathy for both spondylolytic and nonspondylolytic factors.

译文

背景: 腰椎峡部裂的主要临床症状是下腰痛。神经根病很少发生而没有脊椎滑脱。假设年轻运动员的峡部裂会导致腰椎神经根病变。
研究设计: 案例系列; 证据水平,4。
方法: 10 例患者 (男 7 例,女 3 例) 被纳入本研究。患者的年龄从 12 岁到 27 岁不等。我们采用了平片摄影、计算机断层扫描、磁共振成像和必要时的选择性神经根摄影。
结果: 发病机制分为非脊椎型神经根病变 (3 例) 和脊椎型神经根病变 (7 例)。在非脊椎滑脱组中,1 例患者在 L4-5 出现旁节囊肿,2 例患者出现髓核突出。在另一组中,脊椎滑脱相关因素导致神经根病变,所有 7 名患者的脊椎滑脱处于早期或进展阶段。影像学表现表明神经根病是由骨折部位附近的骨外血肿或水肿引起的。神经根病在非手术治疗的一个月内消失,3 到 6 个月后放射学异常消失。
结论: 神经根病可与腰椎峡部裂同时发生,年轻运动员无滑脱。我们认为峡部裂部位的骨外血肿或水肿是导致年轻运动员神经根病的独特病理机制。神经根病在脊椎裂运动员中很少见。磁共振成像是一种有用的工具来阐明导致神经根病变的滑脱和非滑脱因素。

spondylolysis

骨科 腰椎椎弓峡部骨性缺损 疾病
概述  :  

椎弓峡部裂主要是指腰椎椎弓峡部上下关节突间的骨性缺损,为脊椎滑脱的潜在因素。临床上绝大多数腰椎滑脱患者会联合出现椎弓峡部裂,加重患者的腰部疼痛,需要进行及时、有效的治疗。 X线征象椎弓峡部裂患者的X线片特征主要为椎体后缘出现连续性中断,椎间隙变窄,峡部也出现连续性中断,或峡部出现低密度阴影。部分患者的正位片的椎弓根下可见高密度影,且常伴结构紊乱,斜位片则可能出现椎板、峡部发育比较细小等。 CT征象椎弓峡部裂CT影像可发现椎弓根峡部的椎弓关节间的边缘不整齐、宽窄不一致,还可见S形或者

Spondylolysis  /spɔndi'lɔlisis/

释义   n. 脊椎骨脱离,峡部裂,脊椎滑脱

例句   Spondylolysis is a break in the pars interarticularis. 脊椎峡部裂是峡部连续性的中断。

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