Department of Orthopaedic Surgery, Nishitaga National Hospital, Sendai, Japan.
Ups J Med Sci. 2012 Mar;117(1):72-7. doi: 10.3109/03009734.2011.629750. Epub 2011 Nov 23.
Lumbar spondylolysis, a well known cause of low back pain, usually affects the pars interarticularis of a lower lumbar vertebra and rarely involves the articular processes. We report a rare case of bilateral spondylolysis of inferior articular processes of L4 vertebra that caused spinal canal stenosis with a significant segmental instability at L4/5 and scoliosis. A 31-year-old male who had suffered from low back pain since he was a teenager presented with numbness of the right lower leg and scoliosis. Plain X-rays revealed bilateral spondylolysis of inferior articular processes of L4, anterolisthesis of the L4 vertebral body, and right lateral wedging of the L4/5 disc with compensatory scoliosis in the cephalad portion of the spine. MR images revealed spinal canal stenosis at the L4/5 disc level. Posterior lumbar interbody fusion of the L4/5 was performed, and his symptoms were relieved.
腰椎峡部裂,一种常见的腰痛病因,通常累及下腰椎的椎弓峡部,很少累及关节突。我们报告一例罕见的 L4 下关节突双侧峡部裂病例,导致 L4/5 椎管狭窄和显著节段性不稳定以及脊柱侧凸。一名 31 岁男性,自青少年时期即出现腰痛,近期出现右小腿麻木和脊柱侧凸。X 线平片显示 L4 双侧下关节突峡部裂、L4 椎体前滑移以及 L4/5 椎间盘右侧侧方楔形改变,脊柱上段代偿性脊柱侧凸。MR 图像显示 L4/5 椎间盘水平椎管狭窄。行 L4/5 后路腰椎椎体间融合术,患者症状缓解。