Characteristics and diagnostic factors associated with fresh lumbar spondylolysis in elementary school-aged children
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ORIGINAL ARTICLE
Characteristics and diagnostic factors associated with fresh lumbar spondylolysis in elementary school‑aged children Yuta Tsukagoshi1 · Makoto Kamegaya2 · Masaki Tatsumura3 · Yohei Tomaru4 · Hiroshi Kamada4 · Mitsuaki Morita2 · Takashi Saisu2 · Shinsen Nomura5 · Yoshiyasu Ikezawa5 · Masashi Yamazaki4 Received: 5 June 2020 / Revised: 10 July 2020 / Accepted: 23 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose We often encounter elementary school-aged children with fresh lumbar spondylolysis and non-union of bone. They may have factors that impede healing, and treatment outcomes need improvement. The purpose of this study was to investigate elementary school-aged patients with fresh lumbar spondylolysis and to identify characteristics that can aid in prompt diagnosis and proper therapy. Methods We retrospectively compared the characteristics of fresh lumbar spondylolysis in elementary school-aged children with those of older patients. We included patients aged 6–18 years with lower back pain and evidence of bone marrow oedema of lumbar pedicles on magnetic resonance imaging (MRI). The elementary school-aged group (group E) included 100 patients aged 6–12 years, and the senior group (group S) included 251 patients aged 13–18 years. We recorded patient sex, duration of lower back pain, injured site (lumbar level, unilateral/bilateral), presence of contralateral pars defect with evidence of high signal change on MRI (short tau inversion recovery), presence of spina bifida occulta (SBO), and followup treatment interruption rate. Results One-third of the patients in group E were female, and there was an even smaller proportion of females in group S. L5 lumbar spondylolysis was more common in group E. The treatment interruption rate was lower in group E. L5 SBO and contralateral pars defect were more common in group E. Conclusion L5 lumbar spondylolysis, L5 SBO, and contralateral pars defect were important diagnostic factors in elementary school-aged patients. Identification of these characteristics will aid in prompt diagnosis and proper therapy. Keywords Lumbar spondylolysis · Elementary school · Spina bifida occulta · Pseudarthrosis · Pars defect Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00586-020-06553-x) contains supplementary material, which is available to authorized users. * Yuta Tsukagoshi most_valuable_swimmer@tsukuba‑seikei.jp 1
Department of Paediatric Orthopaedic Surgery, Ibaraki Children’s Hospital (Tsukuba Pediatric Orthopaedic Group), Mito City, Ibaraki, Japan
2
Chiba Child and Adult Orthopaedic Clinic (Chiba Pediatric Orthopaedic Group), Chiba City, Chiba, Japan
3
Department of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito City, Ibaraki, Japan
4
Department of Orthopaedic Surgery, University of Tsukuba (Tsukuba Pediatric Orthopaedic Group), Tsukuba City, Ibaraki, Japan
5
Department of Orthopaedic Su
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