Weir M R, Smith D S
Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington 98431-5406.
J Adolesc Health Care. 1989 Nov;10(6):573-7. doi: 10.1016/0197-0070(89)90029-6.
We report an adolescent with progression from a stress reaction of the pars interarticularis without radiographic findings, to radiographic fracture and spondylolysis, illustrating the evolution of spondylolysis in an athletically active early adolescent. Gymnastics, diving, pole vaulting, or collision/contact sports such as football, soccer, hockey, and la crosse are common sports with a disproportional frequency of spondylolysis. Rotational forces around the long axis of the spine with load bearing hyperextension are important in etiology. Low back pain in the active adolescent or preadolescent, even with normal oblique lumbar radiographs, may have a treatable origin--stress reaction or fracture of a lumbar pars interarticularis. Screening evaluation is the standing one-leg extension maneuver. Liberal use of nuclear studies for minimal back symptoms in athletic adolescents may help exclude this relatively common, potentially treatable condition, spondylolysis of the pars interarticularis.
我们报告了一名青少年，其关节突间部从无影像学表现的应力反应发展为影像学骨折和椎弓根峡部裂，说明了在运动活跃的青少年早期椎弓根峡部裂的演变过程。体操、跳水、撑杆跳，或足球、英式足球、曲棍球和长曲棍球等碰撞/接触性运动是椎弓根峡部裂发生率不成比例的常见运动。脊柱长轴周围的旋转力与负重过伸在病因学中很重要。活跃的青少年或青春期前儿童出现腰痛，即使腰椎斜位片正常，也可能有可治疗的病因——腰椎关节突间部的应力反应或骨折。筛查评估是站立单腿伸展动作。对于有轻微背部症状的运动青少年，过度使用核医学检查可能有助于排除这种相对常见、潜在可治疗的疾病——关节突间部椎弓根峡部裂。
