徳島大学 教育・研究者情報データベース(EDB)

1. 眞鍋 裕昭([徳島大学.病院.先端医科医療開発研究プロジェクト]/[徳島大学.病院.診療科.感覚·皮膚·運動機能科.整形外科])

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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. 杉浦 宏祐([徳島大学.大学院医歯薬学研究部.医学域.先端医学教育研究プロジェクト]/[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]/[徳島大学.病院.診療科.感覚·皮膚·運動機能科.整形外科])

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4. 石濱 嘉紘

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5. 手束 文威([徳島大学.大学院医歯薬学研究部.医学域.先端医学教育研究プロジェクト]/[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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6. 山下 一太([徳島大学.大学院医歯薬学研究部.医学域.連携研究部門(医学域).寄附講座系(医学域).地域運動器・スポーツ医学])

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7. 髙田 洋一郎

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8. 前田 徹

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9. 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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(英) Spontaneous Laminar Fracture during Successful Conservative Treatment of Lumbar Spondylolysis at the Adjacent Spinal Level: A Case Report.

(英) Although lumbar spondylolysis (LS) is regarded as a stress fracture, the underlying pathomechanism has yet to be fully elucidated. Here, we present a case that casts doubt on the notion that LS is truly a stress fracture. An 11-year-old female basketball player was brought to our clinic with a 2-week history of persistent low back pain. Magnetic resonance imaging with short TI inversion recovery (STIR-MRI) showed high signal intensity changes at the L4 pedicles bilaterally. Computed tomography (CT) revealed a faint fracture line at the left pars interarticularis. We made a diagnosis of stress fracture and recommended conservative treatment, including cessation of sports activities and wearing of a hard brace. Compliance with treatment was excellent. As expected, the STIR-MRI findings at L4 gradually resolved and bone healing was achieved. However, a follow-up STIR-MRI scan 10 weeks later revealed high signal intensity at the left L5 pedicle. Conservative treatment was continued for the findings at L5, which were considered to indicate a stress fracture (spondylolysis). Five weeks later, CT revealed a bony defect in the lamina at L5 on the left and bone union at L4. Although LS is generally considered to be a stress fracture, there have been several reports of familial occurrence and genetic predisposition. This patient's mother had also been treated for spondylolysis at L5. These observations suggest an underlying genetic etiology in this case.

1. (英) PublicationType: Case Reports