Yabuno Satoru, Yunoki Masatoshi, Kanda Takahiro, Matsumoto Atsushi, Hirashita Koji, Yoshino Kimihiro
Department of Neurosurgery, Kagawa Rosai Hospital, Marugame, Kagawa, Japan.
NMC Case Rep J. 2018 Dec 18;6(1):29-34. doi: 10.2176/nmccrj.cr.2018-0147. eCollection 2019 Jan.
Lumbar spondylolysis is commonly recognized at a single-level of the lumbar spine and frequently affects the L5 pars interarticularis unilaterally or bilaterally. Some reports have described multiple-level spondylolysis, most cases of which occur at consecutive lumbar segments. We herein present a rare case of lumbar spondylolysis involving nonconsecutive multiple-level segments; only eight such cases have been reported previously. A 38-year-old man presented with a 10-month history of chronic severe low back pain. Lumbar flexion-extension radiographs and computed tomography revealed spondylolysis at the level of L3 and L5, whereas no spondylolisthesis was present and the intervertebral disc spaces were maintained at all levels. Because 6 months of conservative management failed and repeated diagnostic blocks confirmed that the fracture of the L3 pars interarticularis was generating pain, repair of the bilateral L3 pars interarticularis with the smiley face rod method was performed. At the last follow-up 1 year after surgery, the patient had resumed normal life as a laborer and reported no back pain.
腰椎峡部裂通常在腰椎的单一节段被发现，并且经常单侧或双侧累及L5关节突峡部。一些报告描述了多节段峡部裂，其中大多数病例发生在连续的腰椎节段。我们在此报告一例罕见的非连续多节段腰椎峡部裂病例；此前仅报道过8例此类病例。一名38岁男性有10个月慢性严重下腰痛病史。腰椎屈伸位X线片和计算机断层扫描显示L3和L5节段存在峡部裂，而不存在椎体滑脱，且所有节段的椎间隙均保持正常。由于6个月的保守治疗失败，且重复诊断性阻滞证实L3关节突峡部骨折产生疼痛，遂采用笑脸棒法对双侧L3关节突峡部进行修复。术后1年的最后一次随访时，该患者已恢复体力劳动者的正常生活，且无背痛报告。
