Helenius Ilkka, Virkki Ella, Toomela Taavi, Studer Daniel, Gehrchen Martin, Ahonen Matti
Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki; Department of Paediatric Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Finland.
Department of Paediatric Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Finland.
Acta Orthop. 2025 Jan 13;96:80-86. doi: 10.2340/17453674.2024.42450.
Spondylolysis is defined as a defect or elongation in the pars interarticularis of the lumbar spine, either unilateral or bilateral. Growing children with bilateral spondylolysis may develop spondylolisthesis, i.e., forward slipping of the affected vertebra. The etiology of spondylolysis is regarded as a stress fracture due to repetitive loading associated with a genetic predisposition. Lumbar magnetic resonance imaging (MRI) shows an increased signal intensity before an actual fracture line develops. In low grade spondylolisthesis, two-thirds of children with acute pediatric spondylolysis will undergo bony union with early activity restriction. Health-related quality of life is improved in patients achieving bony union as compared with patients having non-union, of which one-fourth will additionally develop spondylolisthesis. In patients with high-grade spondylolisthesis, defined as a more than 50% forward slippage of the affected vertebra, spinal fusion is recommended to prevent further progression.
椎弓根峡部裂被定义为腰椎关节突间部的缺损或延长，可为单侧或双侧。患有双侧椎弓根峡部裂的儿童可能会发展为椎体滑脱，即受影响椎体向前滑移。椎弓根峡部裂的病因被认为是由于与遗传易感性相关的反复负荷导致的应力性骨折。在实际骨折线出现之前，腰椎磁共振成像（MRI）显示信号强度增加。在低度椎体滑脱中，三分之二患有急性小儿椎弓根峡部裂的儿童通过早期活动限制将实现骨愈合。与未愈合的患者相比，实现骨愈合的患者的健康相关生活质量得到改善，其中四分之一的患者还会发展为椎体滑脱。在高度椎体滑脱患者中，定义为受影响椎体向前滑移超过50%，建议进行脊柱融合以防止进一步进展。
