Shipley J A, Beukes C A
Department of Orthopaedics, National Hospital, University of the Orange Free State, Bloemfontein, Republic of South Africa.
J Bone Joint Surg Br. 1998 Jul;80(4):662-4. doi: 10.1302/0301-620x.80b4.8323.
We injected methylene blue dye into 32 of the facet joints immediately above the defects in 17 consecutive patients with bilateral spondylolysis (34 defects). In 30 of these the dye flowed into a central cavity in the defect of the pars interarticularis and in 20 it passed into the facet joint below the defect. We found macroscopic cavities in 32 of the defects which communicated with the adjacent facet joints and had fibrous capsules. Histological examination showed focal areas of synovial lining consistent with a synovial pseudarthrosis. In most patients requiring surgery for spondylolysis, the defect is a synovial pseudarthrosis which communicates with the facet joint above it, and less often with the facet joint below it. We suggest that stress fractures of the pars may fail to heal because of the presence of synovial fluid from a nearby facet joint.
我们对17例双侧椎弓根峡部裂（34处缺损）的连续患者中，在缺损上方紧邻的32个小关节内注射了亚甲蓝染料。其中30处染料流入关节突间部缺损处的中央腔隙，20处染料进入缺损下方的小关节。我们在32处缺损中发现了肉眼可见的腔隙，这些腔隙与相邻的小关节相通并具有纤维性包膜。组织学检查显示有与滑膜假关节相符的滑膜衬里局灶区域。在大多数因椎弓根峡部裂需要手术的患者中，缺损是一个与上方小关节相通的滑膜假关节，与下方小关节相通的情况较少见。我们认为，椎弓根应力性骨折可能由于附近小关节的滑液存在而无法愈合。
