徳島大学 教育・研究者情報データベース(EDB)

1. 西良 浩一([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.運動機能外科学])

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2. 酒井 紀典([徳島大学.病院.中央診療施設等.高度先進整形外科診療部])

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3. 安井 夏生

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(英) Conservative treatment of lumbar spondylolysis in childhood and adolescence: the radiological signs which predict healing.

(英) It has been noted that bony union of a pars defect can be achieved in children if they wear a trunk brace. Our aim was to evaluate how the stage of the defect on CT and the presence or absence of high signal change in the adjacent pedicle on T2-weighted MRI were related to bony healing. We treated 23 children conservatively for at least three months. There were 19 boys and four girls with a mean age of 13.5 years (7 to 17). They were asked to refrain from sporting activity and to wear a Damen soft thoracolumbosacral type brace. There were 41 pars defects in 23 patients. These were classified as an early, progressive or terminal stage on CT. The early-stage lesions had a hairline crack in the pars interarticularis, which became a gap in the progressive stage. A terminal-stage defect was equivalent to a pseudarthrosis. On the T2-weighted MR scan the presence or absence of high signal change in the adjacent pedicle was assessed and on this basis the defects were divided into high signal change-positive or -negative. Healing of the defect was assessed by CT. In all, 13 (87%) of the 15 early defects healed. Of 19 progressive defects, only six (32%) healed. None of the seven terminal defects healed. Of the 26 high signal change-positive defects 20 (77%) healed after conservative treatment whereas none of the high signal change-negative defects did so. We concluded that an early-stage defect on CT and high signal change in the adjacent pedicle on a T2-weighted MR scan are useful predictors of bony healing of a pars defect in children after conservative treatment.

1. (英) Adolescent
2. (英) Braces
3. (英) Child
4. (英) Female
5. (英) Fracture Healing
6. (英) Humans
7. (英) Lumbar Vertebrae
8. (英) Magnetic Resonance Imaging
9. (英) Male
10. (英) Pseudarthrosis
11. (英) Spinal Fractures
12. (英) Spondylolysis
13. (英) Tomography, X-Ray Computed
14. (英) Treatment Outcome

1. (英) Article.Affiliation: Department of Orthopaedics, University of Tokushima School of Medicine, 3-18-15, Kuramoto, Tokushima 770-8503, Japan. sairyokun@hotmail.com

2. (英) Article.PublicationTypeList.PublicationType: Journal Article