Sairyo Koichi, Sakai Toshinori, Yasui Natsuo, Kiapour Ali, Biyani Ashok, Ebraheim Nabil, Goel Vijay K
Department of Orthopedics, The University of Tokushima School of Medicine, Tokushima 770-8503, Japan.
Arch Orthop Trauma Surg. 2009 Oct;129(10):1433-9. doi: 10.1007/s00402-008-0795-3. Epub 2008 Dec 16.
Case series and a biomechanical study using a finite element (FE) analysis.
To report three cases with multi-level spondylolysis and to understand the mechanism biomechanically.
Multi-level spondylolysis is a very rare condition. There have been few reports in the literature on multi-level spondylolysis among sports players.
We reviewed three cases of the condition, clinically. These patients were very active young sports players and had newly developed fresh L4 spondylolysis and pre-existing L5 terminal stage spondylolysis. Thus, we assumed that L5 spondylolysis may have increased the pars stress at the cranial adjacent levels, leading to newly developed spondylolysis at these levels. Biomechanically, we investigated pars stress at L4 with or without spondylolysis at L5 using the finite element technique.
L4 pars stress decreased in the presence of L5 spondylolysis, which does not support our first hypothesis.
It seems that multi-level spondylolysis may occur due to genetic and not biomechanical reasons.
病例系列研究以及使用有限元分析的生物力学研究。
报告三例多节段椎弓根峡部裂病例，并从生物力学角度理解其发病机制。
多节段椎弓根峡部裂是一种非常罕见的病症。关于运动员中多节段椎弓根峡部裂的文献报道很少。
我们对三例该病症患者进行了临床回顾。这些患者均为活跃的年轻运动员，新出现了L4新鲜椎弓根峡部裂，且存在L5终末期椎弓根峡部裂。因此，我们推测L5椎弓根峡部裂可能增加了相邻上位节段椎弓根的应力，导致这些节段出现新的椎弓根峡部裂。在生物力学方面，我们使用有限元技术研究了L5有无椎弓根峡部裂情况下L4的椎弓根应力。
存在L5椎弓根峡部裂时，L4椎弓根应力降低，这并不支持我们的第一个假设。
多节段椎弓根峡部裂似乎可能是由遗传因素而非生物力学因素导致的。
