Characteristics and diagnostic factors associated with fresh lumbar spondylolysis in elementary school-aged children.

ABSTRACT

PURPOSE: We often encounter elementary school-aged children with fresh lumbar spondylolysis and non-union of bone. They may have factors that impede healing, and treatment outcomes need improvement. The purpose of this study was to investigate elementary school-aged patients with fresh lumbar spondylolysis and to identify characteristics that can aid in prompt diagnosis and proper therapy. METHODS: We retrospectively compared the characteristics of fresh lumbar spondylolysis in elementary school-aged children with those of older patients. We included patients aged 6-18 years with lower back pain and evidence of bone marrow oedema of lumbar pedicles on magnetic resonance imaging (MRI). The elementary school-aged group (group E) included 100 patients aged 6-12 years, and the senior group (group S) included 251 patients aged 13-18 years. We recorded patient sex, duration of lower back pain, injured site (lumbar level, unilateral/bilateral), presence of contralateral pars defect with evidence of high signal change on MRI (short tau inversion recovery), presence of spina bifida occulta (SBO), and follow-up treatment interruption rate. RESULTS: One-third of the patients in group E were female, and there was an even smaller proportion of females in group S. L5 lumbar spondylolysis was more common in group E. The treatment interruption rate was lower in group E. L5 SBO and contralateral pars defect were more common in group E. CONCLUSION: L5 lumbar spondylolysis, L5 SBO, and contralateral pars defect were important diagnostic factors in elementary school-aged patients. Identification of these characteristics will aid in prompt diagnosis and proper therapy.