Spondylolysis originates in the ventral aspect of the pars interarticularis A CLINICAL AND BIOMECHANICAL STUDY

被引:43
作者
Terai, T. [1 ]
Sairyo, K. [1 ]
Goel, V. K.
Ebraheim, N.
Biyani, A.
Faizan, A.
Sakai, T. [1 ]
Yasui, N. [1 ]
机构
[1] Univ Tokushima, Dept Orthopaed, Sch Med, Tokushima 7708503, Japan
来源
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME | 2010年 / 92B卷 / 08期
关键词
FINITE-ELEMENT-ANALYSIS; PEDIATRIC LUMBAR SPINE; CONSERVATIVE TREATMENT; SPONDYLOLISTHESIS; ADOLESCENTS; CHILDREN; FRACTURE; PEDICLE; DISC;
D O I
10.1302/0301-620X.92B8.22883
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Lumbar spondylolysis is a stress fracture of the pars interarticularis. We have evaluated the site of origin of the fracture clinically and biomechanically. Ten adolescents with incomplete stress fractures of the pars (four bilateral) were included in our study. There were seven boys and three girls aged between 11 and 17 years. The site of the fracture was confirmed by axial and sagittal reconstructed CT. The maximum principal tensile stresses and their locations in the L5 pars during lumbar movement were calculated using a three-dimensional finite-element model of the L3-S1 segment. In all ten patients the fracture line was seen only at the caudal-ventral aspect of the pars and did not spread completely to the craniodorsal aspect. According to the finite-element analysis, the higher stresses were found at the caudal-ventral aspect in all loading modes. In extension, the stress was twofold higher in the ventral than in the dorsal aspect. Our radiological and biomechanical results were in agreement with our clinical observations.
引用
收藏
页码:1123 / 1127
页数:5
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