Spondylolysis in Scheuermann's disease.

Increased lumbar lordosis places increased stress on the pars interarticularis. Fatigue fractures of the pars can result in spondylolysis. There was a 50% incidence of asymptomatic spondylolysis in 18 patients who had Scheuermann's kyphosis and an increased lumbar lordosis. This significant increase further confirms the pathogenesis of spondylolysis. Patients with Scheuermann's disease with low-back pain should be evaluated with oblique radiographs of the lumbar spine to rule out spondylolysis.